AccountId: 011433970860
ContactId: 80421df6-4d8f-4c10-ae32-a99874a24192
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 345480 ms
Total Talk Time (AGENT): 141634 ms
Total Talk Time (CUSTOMER): 56962 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/80421df6-4d8f-4c10-ae32-a99874a24192_20250610T21:06_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi uh my name is [PII], uh, just looking for the status of some claims.
[AGENT][NEUTRAL] OK, well I'll be more than happy to help you with the claim status, [PII]. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] 3
[AGENT][NEUTRAL] OK, and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] no extension.
[AGENT][NEUTRAL] Thank you for that. And may I have the first member's policy number?
[CUSTOMER][NEUTRAL] That would be 02419343.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] Can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] That would be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] That is for 296.
[AGENT][NEUTRAL] And are the other two claims for him as well, or are they different members?
[CUSTOMER][NEUTRAL] Uh, same number.
[AGENT][NEUTRAL] OK, did you want to give the other dates of service and total bills as well?
[CUSTOMER][NEUTRAL] Sure, uh, [PII] for 205.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And [PII] for 296.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So it looks like the policy number that you gave is no longer active. Um, it was effective from [PII], but there is an active policy. Let me get that number and see if the claims are there. Hold on one second.
[AGENT][NEUTRAL] Um, so the active policy number is 255.
[AGENT][NEUTRAL] 644-7.
[AGENT][NEUTRAL] And this policy has been effective since [PII].
[AGENT][NEUTRAL] Let me check the um let me see if there's a claim here for you. Hold on one moment.
[AGENT][NEUTRAL] So there's no claims on file for [PII] or [PII], but there is a claim on file for the [PII]. Um, hold on, I'm waiting for it to come up now.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on file?
[CUSTOMER][NEUTRAL] Uh, this will be [PII]'s office.
[AGENT][NEUTRAL] OK, this is it.
[AGENT][NEUTRAL] And again, just for the call, all the information provided is a verification of benefits, not a guarantee of payment. So I'm showing that this claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 360.
[AGENT][NEUTRAL] 359 8.
[AGENT][NEUTRAL] And on [PII], the claim was denied because office visits are not covered on this policy.
[CUSTOMER][NEUTRAL] I'm sorry, what was the day that um this on?
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] It was received on [PII] and it was processed on [PII].
[CUSTOMER][NEUTRAL] And can I have a
[CUSTOMER][NEUTRAL] PO box to resubmit the other claims.
[AGENT][NEUTRAL] Sure, our PO box is 248.
[AGENT][NEUTRAL] 950.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][POSITIVE] Perfect. And can I also have a reference number?
[AGENT][NEUTRAL] Sure. Um, so there's no call reference number, but you can use my name in today's date. And again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Perfect. Alright, [PII], well, thank you very much. You have a wonderful day.
[AGENT][POSITIVE] You also, was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][POSITIVE] Alrighty. Well, thank you so much for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.