AccountId: 011433970860
ContactId: 7d7859c3-498a-45d2-bb96-ccafb6d1be69
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 705940 ms
Total Talk Time (AGENT): 151943 ms
Total Talk Time (CUSTOMER): 132755 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/7d7859c3-498a-45d2-bb96-ccafb6d1be69_20250602T16:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] This is [PII] calling on office to check on the time status.
[AGENT][NEUTRAL] OK, I could check on the client for you and uh can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] 01723392 M as in Mike L as in Lima.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII] like Eli on the patient but is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII], double the amount is.
[CUSTOMER][NEUTRAL] $3,344.
[CUSTOMER][NEUTRAL] Even
[AGENT][NEUTRAL] OK, that was [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] So we did receive this claim and uh we were unable to pay a benefit uh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] These services were rendered after this policy was terminated. This policy's termination date was [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I have your name, please?
[AGENT][NEUTRAL] My name is [PII], it's [PII]
[CUSTOMER][NEUTRAL] May I have the received date?
[AGENT][NEUTRAL] Yes, one moment.
[AGENT][NEUTRAL] This claim was received [PII], and it was processed on [PII].
[CUSTOMER][NEUTRAL] OK. May I have the claim status?
[AGENT][NEUTRAL] It it did deny as the services were rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] May I have the claim number?
[AGENT][NEUTRAL] That is 3607002.
[CUSTOMER][NEUTRAL] OK, may I have the copy of you be through fax. I have a fax number.
[AGENT][NEUTRAL] Of course, what was that fax number?
[CUSTOMER][NEUTRAL] Wait for a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It was [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII]?
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, I will go ahead and get that sent now. I should get it within about 10 minutes or so. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Just wait for a moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] May I have the call reference of this patient?
[AGENT][NEUTRAL] Reference number would be my first name, last initial, and today's date. Uh so my name is spelled [PII]
[CUSTOMER][NEUTRAL] OK, wait for a moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] May I go to another member?
[AGENT][NEUTRAL] We were checking another claim for a different member, is that right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's from another, another member.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] OK, that's, uh, yeah, if you, uh, you can go ahead and give me that next policy number.
[CUSTOMER][NEUTRAL] 0185 0635.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Do you have that date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what was that bill amount, please?
[CUSTOMER][NEUTRAL] $12,356 even.
[AGENT][NEUTRAL] OK, was that the amount before or after major medical paid [PII]?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Was that the amount before or after major medical paid?
[CUSTOMER][NEUTRAL] Are you there?
[AGENT][NEUTRAL] Can you hear me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, wait for a moment.
[AGENT][NEUTRAL] OK, I do believe I found it. Was that remaining balance was that $2,133?
[CUSTOMER][NEUTRAL] The date of
[CUSTOMER][NEUTRAL] The date of service is [PII]. The bill amount is $12,536 even.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right. The amount after major medical paid was that $2,133.
[CUSTOMER][NEUTRAL] You paid the amount?
[AGENT][NEUTRAL] We, the bill amount we received for this claim was $2,133 and we did pay that benefit.
[CUSTOMER][NEUTRAL] OK. May I have the copy of your be through fax?
[AGENT][POSITIVE] Yes, I'll go ahead and send that to you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, may I have the receipt?
[CUSTOMER][NEUTRAL] Have they received it?
[AGENT][NEUTRAL] Yes, one moment.
[AGENT][NEUTRAL] That was [PII], and it was processed on [PII].
[CUSTOMER][NEUTRAL] May I have the claim number?
[AGENT][NEUTRAL] Yes, that is uh 36.
[AGENT][NEUTRAL] 05245.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mo.
[CUSTOMER][NEUTRAL] May I go to another member?
[CUSTOMER][POSITIVE] Hey good have you OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Are you there?