AccountId: 011433970860
ContactId: 6a314165-e7c8-4624-a0f4-a72aaa153be9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 416839 ms
Total Talk Time (AGENT): 101173 ms
Total Talk Time (CUSTOMER): 76010 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/6a314165-e7c8-4624-a0f4-a72aaa153be9_20250505T18:11_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from border office. I'm checking for claim status.
[AGENT][POSITIVE] All right, [PII], I'm happy to check on a claim for you. What's the policy number?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] It is 0170.
[CUSTOMER][NEUTRAL] 16
[CUSTOMER][NEUTRAL] 06.
[AGENT][NEUTRAL] And if I could have the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] First name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what is the date of service?
[CUSTOMER][NEUTRAL] [PII] build amount $109 even.
[AGENT][NEUTRAL] OK. One moment.
[AGENT][NEUTRAL] Thank you for your patience on that. So it looks like we did receive a claim for the state of service claim was received [PII].
[AGENT][NEUTRAL] Claim was denied [PII]. Services were rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] After coverage, OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you verify that any other insurance active this data service?
[AGENT][NEUTRAL] Uh, there's no other policy active with us at this time.
[CUSTOMER][POSITIVE] Thank you so much for the information. Can I get the date of October?
[AGENT][NEUTRAL] I'm sorry, what was that again?
[CUSTOMER][NEUTRAL] Can I get the claim denial date?
[AGENT][NEGATIVE] A claim again was received on.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then claim was processed and denied [PII].
[CUSTOMER][NEUTRAL] The [PII].
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. I have one more claim. Can I get call reference number, this claim?
[AGENT][NEUTRAL] Call references my name with my last initial then today's date.
[AGENT][NEUTRAL] My name again is [PII], that's [PII]
[CUSTOMER][NEUTRAL] Can you spell out your name?
[AGENT][NEUTRAL] Last initials [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] All right, let me just notate this and then we can check the next one, [PII], one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you need the claim number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Claim number is 3515245.
[CUSTOMER][NEUTRAL] OK, tell me more extra clip.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] What's the next policy number?
[CUSTOMER][NEUTRAL] It is 0246.
[CUSTOMER][NEUTRAL] 55
[CUSTOMER][NEUTRAL] 04.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII]. Last name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII] build amount.
[CUSTOMER][NEUTRAL] $54 even.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][POSITIVE] I appreciate your patience. Just one more moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] We received this claim, um, it looks like it was denied needing the explanation of benefits from the primary.
[CUSTOMER][NEUTRAL] I need a fast finish. OK, one moment.
[CUSTOMER][NEUTRAL] OK, can I get primary?
[AGENT][NEUTRAL] We do not have that information. You would have to contact the insured.
[CUSTOMER][POSITIVE] OK, thank you. OK.
[CUSTOMER][POSITIVE] That's all for today. Thank you for assisting me. Have a nice day. Bye for now.
[AGENT][NEUTRAL] You too, [PII]. Bye.