AccountId: 011433970860
ContactId: 6fc73edf-8663-4678-8290-371c7b25bd34
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 736270 ms
Total Talk Time (AGENT): 172264 ms
Total Talk Time (CUSTOMER): 178310 ms
Interruptions: 2
Overall Sentiment: AGENT=0, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/6fc73edf-8663-4678-8290-371c7b25bd34_20250609T18:39_UTC.wav
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[CUSTOMER][NEUTRAL] This is [PII] calling from office to check on status.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] No, no.
[AGENT][NEUTRAL] I can help you with claim status. Can I get your name one more time?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, my name is [PII] spelled like [PII]
[AGENT][POSITIVE] And a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] policy number will be 02493398 M.
[CUSTOMER][NEUTRAL] Letter 7.
[AGENT][NEUTRAL] OK, I have 02493398, is that correct?
[CUSTOMER][NEUTRAL] 93
[CUSTOMER][NEUTRAL] M like Mary, L like Lima, and 7.
[AGENT][NEUTRAL] And what is the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII] with [PII].
[CUSTOMER][NEUTRAL] And the patient date of birth is [PII].
[AGENT][NEUTRAL] What did you say the name was?
[CUSTOMER][NEUTRAL] Oh, the last name could be spelled that is [PII]
[CUSTOMER][NEUTRAL] And the first name [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And and do the policy number one more time because I don't have that person on there. Let me verify the policy number.
[CUSTOMER][NEUTRAL] 02493393
[CUSTOMER][NEUTRAL] M like [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said date of birth one more time?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you so much and do you have the claim number or the date of service?
[CUSTOMER][NEUTRAL] Uh, the date of service [PII] for the total charge $324 even 3 to $4 even.
[AGENT][NEUTRAL] OK, give me just one moment to look that up.
[CUSTOMER][NEUTRAL] Not not left in the phone.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] And you said $324 correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have my
[AGENT][NEUTRAL] OK, it looks like we received this claim on [PII].
[CUSTOMER][POSITIVE] Great
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] That
[CUSTOMER][POSITIVE] Yeah I take one.
[AGENT][NEUTRAL] Claim number is 35.
[AGENT][NEUTRAL] 86144.
[AGENT][NEGATIVE] And it looks like this claim was denied.
[AGENT][NEUTRAL] Um, office visits are not covered.
[AGENT][NEUTRAL] Under this policy.
[AGENT][NEGATIVE] And it looks like the other three charges, uh, this policy doesn't provide a benefit of services in which no charges were incurred, so I guess their, their primary insurance must have paid all of it for the other 2, but it got denied because office visits aren't covered.
[CUSTOMER][POSITIVE] The best tax day will be, ma'am.
[AGENT][NEUTRAL] Give me just one moment.
[AGENT][NEUTRAL] Give me just one second to pull it up.
[CUSTOMER][POSITIVE] Sure, ma'am, take your time.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] And who do you want the attention to go to?
[CUSTOMER][POSITIVE] Thank you so my name is [PII].
[AGENT][NEUTRAL] Can you spell that for me one more time, please?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] Alright, give me just one moment.
[AGENT][NEUTRAL] And what is the fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And to verify I have [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh no, no, it's [PII].
[AGENT][NEUTRAL] [PII], 233? OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I just sent that over.
[CUSTOMER][POSITIVE] So, when will be, it'll be nice.
[AGENT][NEUTRAL] Uh, you should be able to expect it within a few hours.
[AGENT][NEUTRAL] Is there anything else I can help, is there anything else I can help you with?
[CUSTOMER][NEUTRAL] And I can remember.
[CUSTOMER][NEUTRAL] And I don't have two claims with the same patient with a different type of service. Could you please help me on that?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, you have another claim?
[CUSTOMER][NEUTRAL] And the two, the same patient.
[AGENT][NEUTRAL] Same patient? OK.
[CUSTOMER][NEUTRAL] Oh, the next date of.
[CUSTOMER][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] For the total charge of 6 $61 even and I need uh you will be to be faxed for this also.
[AGENT][NEUTRAL] Alright, what and what was the date of service one more time?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, give me just one moment.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Give me just one moment.
[AGENT][NEUTRAL] And you said $661 or $664?
[CUSTOMER][NEUTRAL] Yes, ma'am. $661.
[AGENT][NEUTRAL] Just.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like we received that claim on the same day, uh, [PII]. It was processed on [PII].
[CUSTOMER][NEUTRAL] I have a
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I have details, ma'am. I need uh UOP to be faxed.
[AGENT][NEUTRAL] Oh, you just need it faxed, OK.
[AGENT][NEUTRAL] Give me just a sec.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just one moment while I send that to you.
[AGENT][NEUTRAL] OK, and I just sent that one over.
[CUSTOMER][NEUTRAL] And I do have one more from the last place the same patient with a different date of service and uh even I need the year before that.
[AGENT][NEUTRAL] OK, and what was the date of service for that one?
[CUSTOMER][NEUTRAL] Uh, [PII] for the total charge of $599 599 dollars.
[AGENT][NEUTRAL] OK, give me just a second.
[CUSTOMER][POSITIVE] Yeah, ma'am, take your time.
[AGENT][NEUTRAL] Give me just one moment while I pull that up.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and I just sent that last one as well. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Oh, no, ma'am. Can I call this number and your name?
[AGENT][NEUTRAL] So we don't have, we don't have call reference numbers, but you can use my name and last initial in today's date so [PII] in today's date.
[CUSTOMER][POSITIVE] Thank you so much. Thank you so much for assisting me, ma'am.
[AGENT][POSITIVE] Alright, if there's nothing else I can help you with, thank you so much for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] I put.