AccountId: 011433970860
ContactId: 8e75e505-6ba7-4438-a9a7-b6db13e70e41
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 162080 ms
Total Talk Time (AGENT): 62768 ms
Total Talk Time (CUSTOMER): 76038 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/8e75e505-6ba7-4438-a9a7-b6db13e70e41_20250311T14:01_UTC.wav
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[AGENT][NEUTRAL] APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from the product's office to check on the claim status.
[AGENT][POSITIVE] Surely, I can assist you with that. Can I have a call back number for you and that policy number?
[CUSTOMER][NEUTRAL] You can.
[CUSTOMER][NEUTRAL] Callback number is [PII], sorry, callback number is [PII]. It's a direct line. And the policy number is 02460750.
[AGENT][NEUTRAL] And what is that member's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, sure. The first name spell it as [PII], and the last name is [PII]. Date of birth for the member is [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you're calling to check the status of a claim? Is it for medical or dental?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] Uh, it's on [PII].
[AGENT][NEUTRAL] Thank you. It looks like we received the claim, however, the services were not covered under the policy.
[CUSTOMER][NEUTRAL] And it's for $723 even.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK. Can I get the issue date and the processed date?
[AGENT][NEUTRAL] Sure.
[AGENT][NEGATIVE] We received the claim [PII]. It was processed [PII], and there was no payment made on the claim because the coverage, the services are not covered under the policy.
[CUSTOMER][NEUTRAL] OK, he's not called on the patient's plan, right? Uh, just a quick minute.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Could you repeat yourself, please?
[CUSTOMER][NEUTRAL] OK. And uh can I get the claim, uh claim number is uh 353-8289, right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] And uh for 700, um, for a total bill amount, uh, patient is responsibility, we can bill the patient for this amount.
[AGENT][NEUTRAL] So this is not a primary insurance company, so I'm not able to, I'm not allowed to tell you that [PII], however, you submitted a claim for $723 we didn't make a payment.
[CUSTOMER][POSITIVE] OK, no problem. Thank you so much. And um yeah, I'm asking that uh OK.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Nothing. Can I get the first initial to your last name?
[AGENT][NEUTRAL] So the first initial, my last name is [PII] and unfortunately we don't provide reference number so you can use my name in today's date as a reference.
[CUSTOMER][POSITIVE] Thank you so much and have a great day.
[AGENT][POSITIVE] Thanks for calling APA. You have a great one as well, [PII]. Goodbye.
[CUSTOMER][NEUTRAL] Bye bye.