AccountId: 011433970860
ContactId: aa56a73d-8d71-425c-be5e-d8843ccb016f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 314579 ms
Total Talk Time (AGENT): 79946 ms
Total Talk Time (CUSTOMER): 156984 ms
Interruptions: 4
Overall Sentiment: AGENT=1.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/aa56a73d-8d71-425c-be5e-d8843ccb016f_20250625T19:27_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], I, I'm sorry I probably shouldn't have called this line, but um, I have [PII] on the phone. Her call back number is [PII], and again I apologize for trans I I dis disconnected and call where I was supposed to, but she's calling on a claim.
[CUSTOMER][NEUTRAL] Um, she said it was P363341.
[AGENT][NEUTRAL] Is that the, that's the claim number?
[CUSTOMER][NEUTRAL] That's what she said, but the policy number she gave was 2144303.
[AGENT][NEUTRAL] You said 214-4303?
[CUSTOMER][NEUTRAL] Uh huh, she didn't give me a name she just gave me the claim number that claim number.
[AGENT][NEUTRAL] OK, so you haven't verified any information?
[CUSTOMER][NEUTRAL] Uh, no, cause she didn't, she, I asked her for that and she said she didn't have it.
[CUSTOMER][NEUTRAL] And she says I have a claim number.
[AGENT][NEUTRAL] OK, because that's not one of our claim numbers. Our claim numbers don't start with, uh, with the initials.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] I didn't think it was.
[CUSTOMER][NEUTRAL] I didn't think it was either.
[CUSTOMER][NEUTRAL] And this policy's been like since [PII].
[CUSTOMER][NEUTRAL] But she's calling on a claim status.
[AGENT][NEUTRAL] OK, then I'll have to verify her information then.
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] Right, well, I mean, like I said, I don't know. I think she's calling from a medical provider, I mean.
[AGENT][NEUTRAL] OK, so it's a provider calling?
[CUSTOMER][NEUTRAL] Facility
[CUSTOMER][NEUTRAL] I think so.
[AGENT][NEUTRAL] OK, and what's the provider's name?
[CUSTOMER][NEUTRAL] Her name is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] She didn't tell my mind. Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, you can um go ahead.
[CUSTOMER][POSITIVE] And again I do apologize [PII].
[AGENT][NEUTRAL] You can go ahead and send it to me.
[CUSTOMER][POSITIVE] Thank you, dear.
[AGENT][POSITIVE] OK, thanks.
[CUSTOMER][POSITIVE] You have a good day.
[AGENT][NEUTRAL] You too.
[AGENT][NEUTRAL] Claims department, this is [PII].
[CUSTOMER][NEUTRAL] Clans department, this is [PII].
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from Mount Sinai Medical Center calling for checking claim status.
[AGENT][NEUTRAL] OK, and may I, may I have the policy number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, let me check.
[CUSTOMER][NEUTRAL] Policy number is 02.
[CUSTOMER][NEUTRAL] 144303.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], may I have the patient's date of birth?
[CUSTOMER][NEUTRAL] [PII]. You got it. May I have the patient's date of birth? Oh, OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, you say you're just checking for claim status?
[CUSTOMER][NEUTRAL] Thank you you say you're just kidding for claim status?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I can help you with that. And do you have the date of service or the claim number?
[CUSTOMER][NEUTRAL] and do you have the date of service or the claim number?
[CUSTOMER][NEUTRAL] Yes, um, 3 [PII].
[AGENT][NEUTRAL] OK, so that's for data service of 320 or 24, and what is the bill amount?
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] The amount is.
[CUSTOMER][NEUTRAL] 337.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, I shall receive that claim in on [PII].
[CUSTOMER][NEGATIVE] Yeah, I can't receive that thing.
[CUSTOMER][NEUTRAL] On [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] It was processed on [PII].
[AGENT][NEGATIVE] Nothing was payable on this claim because the services were rendered after the coverage had terminated.
[CUSTOMER][NEUTRAL] Nothing was said on this claim because the services were rendered afterward service had terminated.
[AGENT][NEUTRAL] The coverage turned [PII].
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] OK, so the member, um, the patient was not active by date of service, right?
[AGENT][POSITIVE] Correct, their policy terms.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for confirming and do you have a reference number for this call?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] It'll be just my name in today's date and that's [PII] spelled [PII] A. Is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] just my name in today's date.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] OK, well thanks for calling APO. You have a good day.
[CUSTOMER][POSITIVE] Thanks for calling you have a good day. You too.
[AGENT][POSITIVE] Thanks, bye.