AccountId: 011433970860
ContactId: 8bbd89d6-7760-43fb-93db-95f309abd29b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 207110 ms
Total Talk Time (AGENT): 69628 ms
Total Talk Time (CUSTOMER): 54125 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/8bbd89d6-7760-43fb-93db-95f309abd29b_20250310T14:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, sir. Uh, my name is [PII] calling from provider's office. Please check on the clarification for claim.
[AGENT][POSITIVE] OK, I'm happy to check on a claim for you today. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is.
[CUSTOMER][NEUTRAL] 02487134.
[CUSTOMER][NEUTRAL] Wait.
[CUSTOMER][NEUTRAL] Is that the right one? I have another.
[AGENT][NEUTRAL] Uh, let me check. One moment.
[AGENT][NEUTRAL] What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, what's the date of service?
[CUSTOMER][NEUTRAL] It's [PII]. Bill the amount is $2000 even.
[AGENT][NEUTRAL] $2000 even.
[CUSTOMER][POSITIVE] Yes, that's right.
[AGENT][NEUTRAL] OK. One moment, [PII], let me take a look.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And I have the claim number?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, yes, so it looks like we did receive a claim. Do you have the claim number there?
[CUSTOMER][NEUTRAL] Yes, it is 356-450.
[AGENT][NEUTRAL] Mhm. Correct. So it looks like the claim was received on [PII], denied [PII].
[AGENT][NEUTRAL] It looks like the member's plan was not eligible at the time of service.
[CUSTOMER][NEUTRAL] So the member's plan was not eligible, right?
[AGENT][NEUTRAL] Correct, they were not active on the time of service. Members plan lapsed [PII].
[CUSTOMER][NEUTRAL] [PII]. And when was he become active again?
[AGENT][NEGATIVE] There is no active plan for the member.
[CUSTOMER][NEUTRAL] OK, so he just turned on [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And do you have any other
[CUSTOMER][NEUTRAL] Coverage for the member.
[AGENT][NEUTRAL] No, I do not.
[CUSTOMER][POSITIVE] OK, thank you. And then,
[CUSTOMER][NEUTRAL] Thank you sir and can I get the call reference number?
[AGENT][NEUTRAL] Call references my name with my last initial than today's date. My name again is [PII], which is [PII] My last initial is [PII].
[CUSTOMER][POSITIVE] OK. Thank you, sir, and have a great day. Bye for now.
[AGENT][NEUTRAL] You too bye bye.