AccountId: 011433970860
ContactId: a504a11b-aeea-4d90-b86f-5c3888e388cb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177830 ms
Total Talk Time (AGENT): 83909 ms
Total Talk Time (CUSTOMER): 75689 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/a504a11b-aeea-4d90-b86f-5c3888e388cb_20250429T13:44_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[AGENT][NEUTRAL] Hey.
[CUSTOMER][NEUTRAL] Yes, hi, good morning, um, I was just calling because I wanted to know why a claim was denied.
[AGENT][POSITIVE] OK, be glad to help you. Go and give me your name and the member's policy number.
[CUSTOMER][NEUTRAL] Um, my name is [PII] and the policy number is, oh sorry, it is 02405912, M for Mary, L for Larry, 8.
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for that information. I will.
[AGENT][NEUTRAL] I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] [PII]. OK, [PII], thank you so much for that information. Now your patient's name and date of birth today, please, ma'am.
[CUSTOMER][NEUTRAL] Yes, uh, her name is [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] you
[AGENT][NEUTRAL] All right. Thank you for all that information. Now you did say you want to check the status of the claim, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] No the service, please, ma'am.
[CUSTOMER][NEUTRAL] Uh, data service was on [PII].
[AGENT][NEUTRAL] And your total bill.
[CUSTOMER][NEUTRAL] $400.
[AGENT][NEUTRAL] 400. And where is the bill gonna be from?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Where's the bill phone provider name?
[CUSTOMER][NEUTRAL] Oh, I'm sorry. It's um for a dermatology office and it's called Steel Creek Dermatology.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well.
[AGENT][NEUTRAL] Alrighty, let's see. It looks like I do see your claim in house um for office visit.
[AGENT][NEUTRAL] An office treatment, yes ma'am, I do see that we have that claim now.
[AGENT][NEGATIVE] Office visits are not covered here.
[AGENT][NEGATIVE] And nothing done in the office is covered here, but you should have got that EOB that that um deny your EOB. You want me to fax you one over.
[CUSTOMER][NEUTRAL] Um, no, I received it, but I just wanted to confirm what I'm reading, you know, sometimes it's not, it's a different kind of English.
[AGENT][NEUTRAL] OK. Yes, ma'am.
[AGENT][NEUTRAL] Yeah, yes, ma'am.
[AGENT][NEGATIVE] I don't have any type of benefits for in the office, OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, so it just, um, we don't, well you guys don't cover, OK, got it.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, ma'am. Is there anything else I can help answer for you today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, no, that was it. Thank you for confirming what I was reading was correct.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, ma'am, Ms. [PII], then well thank you so much for calling APL and you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you so much.
[AGENT][NEUTRAL] Yes, ma'am. Bye-bye.
[CUSTOMER][NEUTRAL] All right bye.