AccountId: 011433970860
ContactId: 758185a3-3e12-4787-801c-6c1d2630722e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 332959 ms
Total Talk Time (AGENT): 117531 ms
Total Talk Time (CUSTOMER): 50352 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/758185a3-3e12-4787-801c-6c1d2630722e_20250415T20:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, my name is [PII]. I'm calling from Britain Business Associates APCDA, and I am uh calling in regards to a claim.
[CUSTOMER][NEUTRAL] Just trying to get a status update on it.
[AGENT][NEUTRAL] Of course, [PII], I can help you with that. What, do you have the policy number for the patient?
[CUSTOMER][NEUTRAL] I do. It is 01792084.
[AGENT][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] And then what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then the patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] I have uh
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] maybe I don't know how you say that.
[AGENT][NEUTRAL] Oh, I, yeah, I see what you mean. OK.
[AGENT][POSITIVE] You know I can do the best you can, right?
[CUSTOMER][NEUTRAL] Yeah, like.
[AGENT][NEUTRAL] OK, and then do you have a claim number or a data service by chance?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yes ma'am, I have a data service that's gonna be 1212 24.
[AGENT][NEUTRAL] OK, and the
[CUSTOMER][NEUTRAL] Total bill amount would be 190.
[AGENT][NEUTRAL] 190, OK.
[AGENT][NEUTRAL] OK. So, for this claim number, it looks like the received date is [PII]. The process date was [PII].
[AGENT][NEGATIVE] And this claim was denied.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] It looks like office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] And then benefits.
[AGENT][NEUTRAL] are payable only if the major medical insurance provider provides benefits.
[AGENT][NEUTRAL] So this is a meddling policy.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Just one moment. There's 2 remark codes for this one claim number.
[AGENT][NEUTRAL] OK, so it looks like for $160.
[AGENT][NEGATIVE] Office visits are not covered.
[AGENT][NEUTRAL] For the policy.
[AGENT][NEUTRAL] And then for $30.
[AGENT][NEUTRAL] It looks like major medical insurance didn't cover that, so.
[AGENT][NEUTRAL] Um, this policy, which is Medli.
[AGENT][NEGATIVE] Did not provide benefits.
[AGENT][NEUTRAL] And then I also have that claim number if you'd like it.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] It is 357.
[AGENT][NEUTRAL] 8174.
[CUSTOMER][NEUTRAL] I get uh
[CUSTOMER][NEUTRAL] The correct spelling of your name and a good reference number please?
[AGENT][NEUTRAL] Yes, um, my name is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And that's also the reference number?
[AGENT][NEUTRAL] It would be [PII] and then my last initial [PII], and today's date.
[CUSTOMER][POSITIVE] Right. Thank you, Ms. [PII]. I appreciate your time.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, is there anything else I can help you with while I have you on the phone?
[CUSTOMER][NEUTRAL] No, ma'am, that was all.
[AGENT][POSITIVE] OK. Well, thanks for calling APL [PII]. Have a good day.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][NEUTRAL] OK, thanks. Bye.