AccountId: 011433970860
ContactId: b249241b-9fc0-4b9c-b098-708977a2919e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231699 ms
Total Talk Time (AGENT): 82070 ms
Total Talk Time (CUSTOMER): 90665 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/b249241b-9fc0-4b9c-b098-708977a2919e_20250410T12:55_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII]. I'm calling from Orange Jewish Hospital, and I was trying to check the status of a medical claim you submitted for a patient.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the claim status. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes ma'am, uh, contact number [PII], phone number [PII].
[CUSTOMER][NEUTRAL] [PII]. Hold on. I gave you the phone number.
[AGENT][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] Uh, policy number 01.
[AGENT][NEUTRAL] It's early.
[CUSTOMER][NEUTRAL] It is, it is. OK, policy number is 01835839.
[AGENT][NEUTRAL] 01835839
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. May I have the date of service for the claim and the total bill?
[CUSTOMER][NEUTRAL] That the service is [PII] and we bill $4,309.20.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so it looks like we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 357-57007.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[AGENT][NEUTRAL] Because the services were rendered after coverage was terminated.
[AGENT][NEUTRAL] This policy was active from [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, you said it was active from [PII]?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] And do you know if the uh if the denial letter has been sent out already?
[AGENT][NEUTRAL] Yes, it was, but if you need me to, I can fax you a copy of the explanation of benefits.
[CUSTOMER][NEUTRAL] OK, yes, please.
[AGENT][NEUTRAL] OK, what's a good fax number for you?
[CUSTOMER][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And should I put attention [PII]?
[CUSTOMER][NEUTRAL] Uh yes, please, and I spell it [PII]
[AGENT][NEUTRAL] And that's [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Alright, so I'll go ahead and send this over to you now. And was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Uh, no, ma'am, Ms. [PII], thank you so much. I hope you have a great rest of your day.
[AGENT][POSITIVE] Thank you, you also, and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.