AccountId: 011433970860
ContactId: ad2a47c2-2e25-49b7-a138-37fba6ae5938
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249520 ms
Total Talk Time (AGENT): 85477 ms
Total Talk Time (CUSTOMER): 74934 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/ad2a47c2-2e25-49b7-a138-37fba6ae5938_20250523T13:12_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling for provider to check an additional information about the claim that has been denied. Please note this call we monitor and kind of for quality and training purposes.
[AGENT][POSITIVE] OK, sure, I can assist you with claims and [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII], it's a direct line.
[AGENT][NEUTRAL] And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Facilities, um,
[CUSTOMER][NEUTRAL] Cardiovascular musline associates.
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 01071583
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Could you spell your name, please?
[AGENT][NEUTRAL] Sure. My name is [PII]'s [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Patient name is uh [PII]. [PII].
[AGENT][NEUTRAL] May I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] and uh the charge amount is, give me a minute.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] $220 even.
[AGENT][NEUTRAL] OK, [PII]. Let me see if I can find this claim for you and for future you can.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, sorry to interrupt, um,
[AGENT][NEUTRAL] Yes. Mhm.
[CUSTOMER][NEUTRAL] You already received an EOB from your end and uh I could see that the member is not eligible during the coverage.
[AGENT][NEUTRAL] OK, so what information do you need?
[CUSTOMER][NEUTRAL] Could you check on that?
[CUSTOMER][NEUTRAL] Uh, could you check and let me know the denial, please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment, let me look for that information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so we received the claim on [PII], um.
[AGENT][NEUTRAL] And process stating that the policy is terminated during the time of service.
[AGENT][NEUTRAL] Do you need the termination date?
[CUSTOMER][NEUTRAL] Yes, effective date and termination date.
[AGENT][NEUTRAL] Effective date is [PII], terminated [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Do you know, just give me one quick moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me check with this.
[CUSTOMER][NEUTRAL] OK, do you know any other eligible coverage which is active during the date of service?
[AGENT][NEGATIVE] None with us.
[CUSTOMER][POSITIVE] OK, thank you. Thank you for your assistance. It's really helpful. Thank you. Can I have the call reference number, please?
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Bye for now.
[CUSTOMER][POSITIVE] That's all thank you.
[AGENT][POSITIVE] Thank you. Thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Have a good day. Bye for now.
[AGENT][NEUTRAL] And