AccountId: 011433970860
ContactId: 6975c306-9b48-4325-8243-eeec36cf1c9b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184160 ms
Total Talk Time (AGENT): 70605 ms
Total Talk Time (CUSTOMER): 71062 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/6975c306-9b48-4325-8243-eeec36cf1c9b_20250321T16:36_UTC.wav
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[CUSTOMER][NEUTRAL] Huh.
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, good morning. My name is [PII]. I'm calling from Doctor's Hospital of Mantica, and I have a question regarding a claim.
[AGENT][POSITIVE] OK, sure, I can assist you with claims and sending. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] and that's a direct line.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] D 46401306.
[AGENT][NEUTRAL] Do you see a policy certificate number? It's gonna start with a 0 followed by 7 digits. That's gonna be your number, that the number is for IMA.
[CUSTOMER][NEUTRAL] OK, you know what? I have an EOB here. Let's see. Oh, policy number, is that what you need to it's 02494443.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, yes.
[AGENT][NEUTRAL] OK, thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Perfect. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] It's [PII] and 23,62222.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hey, looks like we denied the claim stating that our records indicate that the premium for the data service was not received. Therefore, benefits are not payable. Um, let me check and see if the policy is still active.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the policy has terminated. The termination date is [PII].
[CUSTOMER][NEUTRAL] OK, so whether we pay the premiums or not, it doesn't matter because he was termed anyway, right?
[AGENT][NEUTRAL] Yeah, right now it's terminated, right.
[CUSTOMER][POSITIVE] OK, alright, thank you very much. We'll go ahead and get it out to the member that I just wanted to make sure. Thank you.
[AGENT][POSITIVE] You're welcome. No problem. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] No, that's it for now. Um, what was your name again?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. Last initial [PII] [PII].
[CUSTOMER][POSITIVE] Thank you very much. I appreciate it.
[AGENT][POSITIVE] You're welcome. No problem. Is there anything else I can help you with today, Ms. [PII]?
[CUSTOMER][POSITIVE] That's all I needed for now. Thank you.