AccountId: 011433970860
ContactId: 9f56ef5e-7906-467a-a188-e3ec7c2f42bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163250 ms
Total Talk Time (AGENT): 61470 ms
Total Talk Time (CUSTOMER): 51394 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/9f56ef5e-7906-467a-a188-e3ec7c2f42bf_20250116T19:36_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII].
[CUSTOMER][NEUTRAL] Calling about a claim on a patient.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the claim, [PII]. May I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, [PII], that is a direct line.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the policy number I'm looking at is 021-93101.
[AGENT][NEUTRAL] Thank you. Hold on one moment while I pull up that policy.
[AGENT][NEUTRAL] And [PII], can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] with the date of birth of [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] [PII] $2,543.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Saint Francis Hospital.
[AGENT][NEUTRAL] OK, hold on one moment, 52.
[AGENT][NEUTRAL] OK, um, so I'm showing that the claim was denied because the benefit maximum for the data service was met, and what questions did you have?
[CUSTOMER][NEUTRAL] You say a benefit maximum?
[AGENT][NEUTRAL] Yes, ma'am, for the data. Mhm.
[CUSTOMER][NEUTRAL] On the date of service had.
[CUSTOMER][NEUTRAL] had been met.
[AGENT][POSITIVE] Yes, you got it.
[CUSTOMER][NEUTRAL] And this is a limited plan, correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, I think that gives me what I need. If you could give me a call reference number, that'd be great.
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Well, thank you so much. You have a great rest of your day.
[AGENT][POSITIVE] You also, [PII], thanks for calling ATL.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Uh huh bye bye.