AccountId: 011433970860
ContactId: 7719a53f-e50f-4977-b3c6-3cd4910dcaf1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210990 ms
Total Talk Time (AGENT): 101616 ms
Total Talk Time (CUSTOMER): 48378 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/7719a53f-e50f-4977-b3c6-3cd4910dcaf1_20250530T12:20_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. This is [PII] and I'm calling to uh get information on a claim.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] Thank you and the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] It is 02297025 ML 8 I think that is 8 or 8.
[AGENT][NEUTRAL] It would be an 8. OK, thank you. One moment.
[AGENT][NEUTRAL] And any information that I do provide for you, [PII], will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII], uh [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] [PII] $232 even.
[AGENT][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] OK, so I do show that this claim was received. The claim was received on [PII], and it was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is going to be 355.
[AGENT][NEUTRAL] 9081.
[AGENT][NEUTRAL] And the reason for the denial states benefits payable under this certificate are limited to those on the schedule of benefits. This is not a covered loss under the plan. Therefore, no amount is payable for this expense.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you need a copy [PII] of that explanation of benefits, you should be able to print that directly from our portal now that you have the claim number by going to secured.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, thank you [PII].
[AGENT][POSITIVE] Yes, ma'am. You're welcome.
[CUSTOMER][NEUTRAL] OK, that's all I have. Uh, yeah, well I use your name for my reference number today?
[AGENT][NEUTRAL] And is there
[AGENT][NEUTRAL] Oh, OK. Well,
[AGENT][POSITIVE] You er you certainly will. You'll use my name along with today's date. Mhm.
[CUSTOMER][NEUTRAL] Or do you have a
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, thanks, [PII] have a great day.
[AGENT][POSITIVE] Well, you're very welcome. I hope you have a great day too, [PII], and thank you again for calling APL.
[CUSTOMER][NEUTRAL] OK, bye bye.
[AGENT][NEUTRAL] All right, bye-bye.