AccountId: 011433970860
ContactId: 72541983-97e2-4830-8352-b791a4c22e99
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206880 ms
Total Talk Time (AGENT): 94613 ms
Total Talk Time (CUSTOMER): 58170 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/72541983-97e2-4830-8352-b791a4c22e99_20250108T17:16_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] APO
[CUSTOMER][NEUTRAL] Hello, my name is [PII] calling from Mercy Hospital, checking on a claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status. And for my notes, can you spell your first name for me and provide a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh my name is [PII], that is [PII] and callback number is [PII].
[AGENT][NEUTRAL] Thank you for that, and [PII], how many claims do you have in total today?
[CUSTOMER][NEUTRAL] One
[AGENT][NEUTRAL] And may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] 02069892.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] My name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you'd like me to look at?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Date of service is [PII] and the bill amount is $560 even.
[AGENT][NEUTRAL] And that was 156, I'm sorry, 516.
[CUSTOMER][NEUTRAL] Yeah, 516.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Mercy Hospital Lincoln.
[AGENT][NEUTRAL] Alright, so I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] That claim number is 345.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 4081.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[AGENT][NEUTRAL] Um, I'll spell the first word, Kiology, [PII]
[AGENT][NEUTRAL] Speech and occupational therapy are not covered benefits under this policy.
[CUSTOMER][NEUTRAL] OK. Can you please help me out with the TOP or fax number?
[AGENT][NEUTRAL] Sure, what's your fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And should I put attention, [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, so I am sending this to you now, [PII]. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Can you please spell your name?
[AGENT][NEUTRAL] Sure, my name is [PII]
[AGENT][NEUTRAL] The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Conference number?
[AGENT][NEUTRAL] There's no call reference number, but you can use my name and today's date.
[CUSTOMER][POSITIVE] Thanks for providing information. Have a nice day.
[AGENT][POSITIVE] You're welcome, [PII]. You also, and thanks for calling APL. Bye-bye.