AccountId: 011433970860
ContactId: a50d6749-c31f-48c1-86f5-d95f94219c78
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 267350 ms
Total Talk Time (AGENT): 126369 ms
Total Talk Time (CUSTOMER): 63395 ms
Interruptions: 1
Overall Sentiment: AGENT=2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/a50d6749-c31f-48c1-86f5-d95f94219c78_20250606T12:39_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], my name is [PII] and I'm with Life Link Anesthesia, and I needed to check a claim status.
[AGENT][NEUTRAL] OK [PII], you're needing to check claim status for one member?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII].
[CUSTOMER][NEUTRAL] 01978581
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And any information [PII] that I do provide today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, the first name is [PII], I guess that's how you put [PII], the last name [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the data service and total bill amount please?
[CUSTOMER][NEUTRAL] [PII] $1,335.60.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do see that this claim was received. [PII], the received date on it was [PII].
[AGENT][NEUTRAL] It was processed and denied on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 351.
[AGENT][NEUTRAL] 5350.
[AGENT][NEUTRAL] And the reason for the denial states outpatient benefits for this calendar year has been met.
[CUSTOMER][NEUTRAL] So is this patient responsibility?
[AGENT][NEUTRAL] We do not determine patient responsibility, that would be up to the provider.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] And if you need a copy of that excellent, oh, I'm so sorry. No, go ahead.
[CUSTOMER][NEUTRAL] And is there
[CUSTOMER][NEUTRAL] Yes, yeah, no, no, you're fine that's what I was gonna ask you that's what I was gonna ask.
[AGENT][NEUTRAL] I was gonna say, yes, if you need a copy of that explanation and benefits with that remark, we have a portal that you should be able to print that from now that you have the claim number.
[AGENT][NEUTRAL] And our website for that is located at secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Am public.
[AGENT][NEUTRAL] [PII]. So let me say that again since I can't talk this morning, [PII]. Secured. [PII].
[CUSTOMER][NEUTRAL] OK, and that claim number was 351-535-0.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That is correct, yes ma'am.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, and can I get a reference number please?
[AGENT][NEUTRAL] Sure, you're gonna use my name along with today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright [PII] thank you so much.
[AGENT][POSITIVE] Well, you are very welcome. Is there anything else, [PII], I can help you with this morning?
[CUSTOMER][POSITIVE] Uh, no, that's it right now, thank you.
[AGENT][POSITIVE] OK, well, you're welcome and thank you again for calling APL. I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] You too thanks.
[AGENT][POSITIVE] Yes, ma'am and thank you too. Bye-bye.