AccountId: 011433970860
ContactId: 78717283-4db3-40a6-890d-e5a2d620e997
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 147750 ms
Total Talk Time (AGENT): 62577 ms
Total Talk Time (CUSTOMER): 52469 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/78717283-4db3-40a6-890d-e5a2d620e997_20250220T14:51_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, sir. My name is [PII] calling you from provider's office, checking on claim status.
[AGENT][NEUTRAL] Sure, Mr. [PII], I can assist you with claim status. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, it is [PII]. It's the direct line.
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02462264 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is [PII] S. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you and may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah, date of service is [PII]. Total charge $324 even.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] OK, let me see if I can find this claim and for future you can check claim status online through our website at [PII] and that's just optional, give one moment.
[AGENT][NEUTRAL] OK, looks like we received the claim on [PII]. We processed the claim on [PII], and the claim was denied. The denial reason is that office visits are not covered by the policy under the member's plan.
[CUSTOMER][NEUTRAL] OK, office visits are not covered. OK. And can I get the claim number, please?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm. Sure, that's 356-008-6.
[CUSTOMER][NEUTRAL] Just to confirm, it is 356-0086. I'm right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, sure. And may I have your name spelled, please?
[AGENT][NEUTRAL] Sure. That's [PII].
[CUSTOMER][POSITIVE] OK, sure. It was great speaking with you. Have a good day. Bye-bye.
[AGENT][POSITIVE] You as well thank you for calling APR. Bye bye.