AccountId: 011433970860
ContactId: 93811e22-de4c-45cf-83af-bef6bf1f0a33
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 422339 ms
Total Talk Time (AGENT): 154545 ms
Total Talk Time (CUSTOMER): 60426 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/93811e22-de4c-45cf-83af-bef6bf1f0a33_20250403T16:47_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was calling to see if you can help me with claim status.
[AGENT][NEUTRAL] OK. I'm so sorry. We, you sound like you're a long way away from the phone. Did you say that you were needing plan?
[CUSTOMER][NEUTRAL] If you can help me
[CUSTOMER][NEUTRAL] Can you help me with claim status?
[AGENT][NEUTRAL] OK, you're needing claim status. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII] and what's your last initial?
[AGENT][NEUTRAL] S
[AGENT][NEUTRAL] And [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] 1
[AGENT][NEUTRAL] OK, and what is that member's policy number, please?
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] 01594460
[AGENT][NEUTRAL] OK, thank you. One moment please.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] And what is the date of service and total bill amount for him, [PII]?
[CUSTOMER][NEUTRAL] It services 21825 228.
[AGENT][NEUTRAL] OK, [PII], is that correct?
[CUSTOMER][NEUTRAL] No ma'am, 21825 for the amount of $228.
[AGENT][NEUTRAL] Oh, OK. I'm so sorry. It's 228. OK. It's the build out. All right, one moment.
[AGENT][NEUTRAL] OK, so yes, ma'am, this claim was received. The received date was [PII].
[AGENT][NEUTRAL] Processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 357.
[AGENT][NEUTRAL] 661 7.
[AGENT][NEUTRAL] And the denial remark reads as follows, inpatient benefit for this calendar year has been met.
[CUSTOMER][NEUTRAL] Inpatient
[AGENT][POSITIVE] Benefit for this calendar year has been met.
[AGENT][NEUTRAL] And [PII], if you need a copy of this explanation of benefits now that you have the claim number, you should be able to print that directly from our portal.
[AGENT][NEUTRAL] By going to secured.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Are, are you able to fax or email it to us, to email me?
[AGENT][NEUTRAL] I can fax it if you're not able to print it.
[AGENT][NEUTRAL] So just a moment.
[CUSTOMER][NEUTRAL] Could you fax it for me?
[AGENT][NEUTRAL] Just a moment while it loads.
[AGENT][NEUTRAL] Just the fax, once it loads, does that need to be put to your attention, [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] [PII] is the name spelled [PII]
[AGENT][NEUTRAL] Neither [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's still loading your information.
[AGENT][NEUTRAL] And what is your fax number, please, [PII]?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, again, that was [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK. Well, I have just faxed that to you. So provided that there's not any difficulty with it being received, you should be receiving that very shortly.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] And is there anything else? You're welcome. Is there anything else I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] Just the reference number.
[AGENT][NEUTRAL] You would use my name along with today's date.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You are certainly very welcome and thank you for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Good thank you.
[AGENT][NEUTRAL] Ah,