AccountId: 011433970860
ContactId: 9925a4ce-019a-440f-ab04-627b1e01fd87
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 138820 ms
Total Talk Time (AGENT): 49869 ms
Total Talk Time (CUSTOMER): 77359 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/9925a4ce-019a-440f-ab04-627b1e01fd87_20250331T19:09_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I am calling from a provider's office, um, in regards to one of our patients. Would you be able to verify for me, um, he had an echocardiogram done in the office.
[CUSTOMER][NEUTRAL] And his insurance says um outpatient benefit cert certification number, but now we got the claim back that it doesn't cover in office. Would you be able to verify if it only covers hospital, his specific plan, please?
[AGENT][NEUTRAL] Certainly. May I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. What is your callback number?
[CUSTOMER][NEUTRAL] Last name is [PII], yes, [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what is that policy number, please?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] It is 02424707 M as in mama, L as in Larry, and the number 8.
[AGENT][NEUTRAL] OK, thank you very much and verify the member's name and date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you very much. And what is that claim number on the EOB please?
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] I don't have it. Can I give you the date of service and the amount?
[AGENT][NEUTRAL] Sure. Yes.
[CUSTOMER][NEUTRAL] Date of service was [PII].
[CUSTOMER][NEUTRAL] And the bill amount was 488.
[AGENT][POSITIVE] 488. Thank you.
[CUSTOMER][NEUTRAL] $488.
[AGENT][NEUTRAL] OK, right. I have that pulled up here. It's number 3579246. OK, thank you. Uh, yes, this plan that he has, it does not cover procedures or services inside the doc doctor's office.
[CUSTOMER][NEUTRAL] Oh, so it's only hospital only.
[AGENT][NEUTRAL] Um, ER, um, urgent care, but not in the office, doctor's office.
[CUSTOMER][NEUTRAL] OK, let me go ahead and write that down here. Can I get a reference number please?
[AGENT][NEUTRAL] We do not use reference numbers. You can use my name. My last initial is [PII], first name is [PII], and today's date.
[CUSTOMER][POSITIVE] Thank you and have a great day, OK?
[AGENT][POSITIVE] You as well and thank you for calling ATL and take care.
[CUSTOMER][POSITIVE] Alrighty bye bye.
[AGENT][NEUTRAL] OK.