AccountId: 011433970860
ContactId: 86fdaed9-e300-4c61-9689-26394915d4b5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 153460 ms
Total Talk Time (AGENT): 31510 ms
Total Talk Time (CUSTOMER): 85667 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/86fdaed9-e300-4c61-9689-26394915d4b5_20250508T16:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. Last name initial [PII]. Calling for Bora's office to check on additional information about a claim that has been denied. Please note this call be recorded and monitored for quality and training purposes. How you today [PII]?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][POSITIVE] I'm doing OK, thanks for asking.
[AGENT][NEUTRAL] OK, and can I get the provider's name and a good callback number?
[CUSTOMER][NEUTRAL] Sure. The group name is Omni Medical Group INC. Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII] it's a direct line.
[AGENT][NEUTRAL] OK, thank you, and I can help you with claim status. Do you have a good policy number for that patient?
[CUSTOMER][NEUTRAL] Sure. Policy number is
[CUSTOMER][NEUTRAL] 021
[CUSTOMER][NEUTRAL] 02325.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], it's [PII].
[CUSTOMER][NEUTRAL] date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. And the bill charges, uh, date of service and bill charges?
[AGENT][NEUTRAL] Or if you have a claim number.
[CUSTOMER][NEUTRAL] Sure, it was March 25.
[CUSTOMER][NEUTRAL] Uh, let me check, mm.
[CUSTOMER][NEUTRAL] of service was March 2025, [PII]. Total charge is $257 even.
[CUSTOMER][NEUTRAL] Let me check whether I have a claim number or not.
[CUSTOMER][NEUTRAL] Well, actually it shows here, uh, we got a you'll be that services rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] So I have a reference number here.
[CUSTOMER][NEUTRAL] And the claim number is 359.
[CUSTOMER][NEUTRAL] 1538.
[AGENT][NEUTRAL] OK, thank you. Uh, so the policy terminated [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Thank you. And uh mm, you please check uh what the member had any other coverage, any other secondary coverage on the data service.
[AGENT][NEUTRAL] Uh, I don't show any other coverage on file.
[CUSTOMER][NEUTRAL] You have that information, let me know.
[CUSTOMER][NEUTRAL] OK, no other coverage, OK.
[CUSTOMER][NEUTRAL] And what's the call reference number for conversation, [PII]?
[AGENT][NEUTRAL] Uh, it's my name is [PII], and today's date.
[CUSTOMER][POSITIVE] Thank you, [PII]. Thank you for your wonderful assistance. Have a great day and stay safe. Bye-bye.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye-bye.