AccountId: 011433970860
ContactId: 77e99276-a148-4e7e-bddf-2f85e4a1a2eb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 134470 ms
Total Talk Time (AGENT): 53374 ms
Total Talk Time (CUSTOMER): 52762 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/77e99276-a148-4e7e-bddf-2f85e4a1a2eb_20250506T15:47_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I was just calling to um see why a claim was denied. I'm not sure who I need to speak with because it's for a medical office visit.
[AGENT][NEUTRAL] This is the claims department. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and [PII].
[AGENT][NEUTRAL] And [PII], what is the policy number of the member that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] It is 02573615.
[CUSTOMER][NEUTRAL] What's the word.
[AGENT][NEUTRAL] What's the member's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you, to check the status of a claim for what date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your procedure code?
[CUSTOMER][NEUTRAL] It is 99213.
[AGENT][NEUTRAL] And we made a payment of $50 which was full benefit amount for office visit.
[CUSTOMER][NEUTRAL] I'm sorry you cut out and I didn't hear you.
[AGENT][NEUTRAL] And we made a payment of $50 for the full amount for the office visit.
[CUSTOMER][NEUTRAL] OK, the remit that I received showed that there was a payment of $0.
[AGENT][NEUTRAL] There was a payment made on [PII] for $50. Would you like the check number?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] 204-213-7.
[CUSTOMER][POSITIVE] Perfect, and then if I could just get a reference number from you.
[AGENT][NEUTRAL] We don't provide those. We don't provide those, [PII]. However, you can use my name and today's date as a reference is [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much.
[AGENT][POSITIVE] You're welcome, thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Uh