AccountId: 011433970860
ContactId: 6a15c9ce-80ca-4c66-bacc-049acf55a256
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 447380 ms
Total Talk Time (AGENT): 118096 ms
Total Talk Time (CUSTOMER): 136087 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/6a15c9ce-80ca-4c66-bacc-049acf55a256_20250618T19:50_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. This is [PII] calling from provider's office to check the claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, Mr. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Oh yeah, sure. It's [PII].
[AGENT][NEUTRAL] Thank you. May I have the name of the facility you're calling from, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah, it's Summit Radiology Services.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes. It is D like Delta 43,728,250.
[AGENT][NEUTRAL] OK, um, do you see a policy certificate number? It's gonna start with 0 followed by 7 digits. That's gonna be a number.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Let me check that.
[CUSTOMER][NEUTRAL] But they just have this ID.
[AGENT][NEUTRAL] OK, uh, we will have to do an inser because that's not our policy number, Mister [PII]. What is the spelling of the last name?
[CUSTOMER][NEUTRAL] Yes, uh.
[CUSTOMER][NEUTRAL] Last name is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is the spelling of the first name?
[CUSTOMER][NEUTRAL] Oh yes, it's [PII]. Yes, it's like, [PII].
[AGENT][NEUTRAL] OK, thank you. One moment, let me see if I can find this number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] is
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What is the date of birth?
[CUSTOMER][NEUTRAL] Mm, yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yes. [PII] for $146 even.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And for future you can check claim status online through our website at [PII] and that's just an option.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Yeah, I don't see that claim on file, Mr. [PII].
[CUSTOMER][NEUTRAL] Uh, uh, can I drive with the claim number? I have the claim number.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] OK. It is 353-866-8.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, bear with me just a second, let me pull that in your.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] So waiting on the system.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so that that claim was sent out to um the wrong policy because this policy is a disability policy and we do not cover services like that under this plan.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, we don't have a medical plan for this member.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] stating that the claim was sent to incorrect address or
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The claim was denied. The reason for the denial?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This is a disability income policy only. Bets are not payable for medical services.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So medical service is not covered, OK?
[AGENT][POSITIVE] Correct. Mhm.
[CUSTOMER][NEUTRAL] OK. Thanks for that. I'm sorry, could you please repeat your first name again?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] Thanks, sir. So, OK.
[CUSTOMER][POSITIVE] So this is the reason but thank you so much. And finally, can I get the call reference number, please?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Well, thanks, sir. Thank you so much for your assistance. Have a great day. Stay safe. Bye-bye.
[AGENT][POSITIVE] Yes, sir. Thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Mm bye bye.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um,