AccountId: 011433970860
ContactId: 810f5ad0-a50e-4ac7-8779-25652f0e6471
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266690 ms
Total Talk Time (AGENT): 84198 ms
Total Talk Time (CUSTOMER): 85335 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/810f5ad0-a50e-4ac7-8779-25652f0e6471_20250317T14:18_UTC.wav
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[AGENT][NEUTRAL] For calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Mhm. This is [PII] calling from our provider's office. Um, I want to know the medical claim information of the patient.
[AGENT][NEUTRAL] I can verify claim status. May I have a policy number?
[CUSTOMER][NEUTRAL] Uh one moment.
[CUSTOMER][NEUTRAL] The member ID is 018.
[CUSTOMER][NEUTRAL] 98014.
[AGENT][NEUTRAL] May I have a good callback number for you?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Can you spell your first name, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Can you please verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm. Sure. Patient's name is
[CUSTOMER][NEUTRAL] [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. May I have a date of service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Total bill amount?
[CUSTOMER][NEUTRAL] $574 574.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] to check claim status as well.
[AGENT][NEUTRAL] It looks like this processed under claim number.
[AGENT][NEUTRAL] 356-512-6. No benefits are payable. There is no active policy for this policy terminated.
[AGENT][NEUTRAL] This claim was received on.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] Go ahead. Go ahead.
[AGENT][NEUTRAL] Claim was received on [PII] and then denied on [PII].
[AGENT][NEUTRAL] The policy termed 31-2022.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Can you give me the updated status of the station?
[AGENT][NEGATIVE] There is no active policy on file.
[CUSTOMER][NEUTRAL] All right. Um, just for the confirmation, the claim number is 356512-6, correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] All right. And the receiving date is [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can you repeat that? Is this claim is denied or in process?
[AGENT][NEGATIVE] It is denied.
[CUSTOMER][NEUTRAL] OK. And then may I have the reason of denial?
[AGENT][NEUTRAL] Policy terminating.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And the policy is terminated on, on what date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] May I have reference number?
[AGENT][NEUTRAL] It will be my name which is [PII] Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Thank you so much, there's nothing else.
[AGENT][POSITIVE] Thank you for calling American Public Life, [PII]. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Bye for now.