AccountId: 011433970860
ContactId: 6ff5e469-ae90-4c70-a259-0130cdf0eba2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195600 ms
Total Talk Time (AGENT): 68410 ms
Total Talk Time (CUSTOMER): 60917 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/6ff5e469-ae90-4c70-a259-0130cdf0eba2_20250425T15:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, general payment status.
[AGENT][POSITIVE] OK, I'm happy to check on a claim. What's the policy number, please?
[CUSTOMER][NEUTRAL] Yep, um, the policy number will be.
[CUSTOMER][NEUTRAL] The policy number will be 01991586 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Thank you. May I have your first name and a callback number, please?
[CUSTOMER][NEUTRAL] Yep, uh, my first name is [PII] and callback number will be [PII].
[AGENT][NEUTRAL] And [PII], can I have patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yeah, uh, the patient's name is [PII]. Last name is [PII], and date of birth is [PII].
[AGENT][POSITIVE] Thank you, Da service.
[CUSTOMER][NEUTRAL] Data services will be 0829-2024.
[AGENT][NEUTRAL] And the build amount?
[CUSTOMER][NEUTRAL] Uh, it's $146 even.
[AGENT][NEUTRAL] Hi [PII], thank you for your patience on that. So we did receive a claim for this state of service. Claim was received [PII].
[AGENT][NEUTRAL] The claim was denied on [PII].
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Uh, the services provided were not a covered benefit under this plan. Therefore, there was nothing payable.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Can you give me the claim number?
[AGENT][NEUTRAL] That would be 351-0038.
[CUSTOMER][NEUTRAL] 3 got it.
[CUSTOMER][NEUTRAL] So, um, uh, can this, uh, claim be reprocessed? This is secondary also.
[AGENT][NEUTRAL] You can resubmit it, however, it looks like services provided are not covered or outlined in the scheduled benefits on the member's plan, so therefore it's not payable.
[CUSTOMER][NEUTRAL] OK, all right, no problem. Uh, can I have a call reference number on this?
[AGENT][NEUTRAL] That would be my name with my last initial and then today's date. My name again is [PII], that is spelled [PII] Last initial is [PII] with today's date.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] All right, sir, thank you for the information and you have a good day, ma'am.
[AGENT][NEUTRAL] You as well bye bye.