AccountId: 011433970860
ContactId: 6d43f77f-df0e-4410-ad78-3f9850eb0d0c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254850 ms
Total Talk Time (AGENT): 105136 ms
Total Talk Time (CUSTOMER): 56810 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/6d43f77f-df0e-4410-ad78-3f9850eb0d0c_20250501T13:26_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm calling in regards to a claim status for a member.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII]. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, it is 778-8982.
[AGENT][NEUTRAL] 7788982
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, that's not an APO policy number. Do you have the ID card available?
[CUSTOMER][NEUTRAL] Um, yes
[CUSTOMER][NEUTRAL] See.
[AGENT][NEUTRAL] On the card, um, you're looking for in-hospital or outpatient policy cert number. It should start with a 01 or 02 unless it's dental, then it would just say policy cert.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] I see a policy er number 778982.
[AGENT][NEUTRAL] What's the member's first and last name?
[AGENT][NEUTRAL] Is it [PII] or 7788?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Um, just [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that's what it was. All right, and I have the number here. Can you verify the date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And um this is for, what's the first name?
[CUSTOMER][NEUTRAL] Um, first name is [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And may I have the date of service for the claim?
[CUSTOMER][NEUTRAL] Um, date of service is [PII].
[AGENT][POSITIVE] Thank you. And the total bills.
[CUSTOMER][NEUTRAL] $2,045.
[AGENT][NEUTRAL] $1,045 OK.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Yes, it is Barnes Jewish Hospital.
[AGENT][NEUTRAL] OK, here it is.
[AGENT][NEUTRAL] Alright, so I'm showing we received the claim on [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] That claim
[AGENT][NEUTRAL] The claim number is 358.
[AGENT][NEUTRAL] 841 9.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[AGENT][NEUTRAL] Requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do you all have a fax number?
[AGENT][NEUTRAL] Yes, our fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and lastly, may I have a call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII], and again my name is [PII]
[CUSTOMER][POSITIVE] OK alright well thank you for your help today.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] Alright, well, thanks for calling [PII]. I hope you have a great day.
[CUSTOMER][POSITIVE] Thanks you too.
[AGENT][POSITIVE] Thank you. Bye-bye.