AccountId: 011433970860
ContactId: b314094e-c769-4599-8b20-9caa72f2c221
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 328380 ms
Total Talk Time (AGENT): 91970 ms
Total Talk Time (CUSTOMER): 100252 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/b314094e-c769-4599-8b20-9caa72f2c221_20250128T18:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. Good afternoon. My name is [PII] and last termination for [PII]. I'm calling from provider's office regarding claim status.
[AGENT][NEUTRAL] OK, yeah, I could check on a claim for you, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. [PII].
[CUSTOMER][NEUTRAL] 639-7088
[AGENT][NEUTRAL] Thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, just give me a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Um, the member ID is 1445533 M for Mary, L for Lima, 8.
[AGENT][NEUTRAL] OK, thank you. And uh what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] and the date of birth, [PII].
[AGENT][NEUTRAL] Thank you for verifying that and uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the total charge is $348 even.
[AGENT][NEUTRAL] I'm sorry, that was 314.
[CUSTOMER][NEUTRAL] 348348.
[AGENT][NEUTRAL] 48. OK, thank you. One moment.
[CUSTOMER][NEUTRAL] That's so.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so we did receive this policy, [PII], we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK. And may I know the receipt date and claim number?
[AGENT][NEUTRAL] Yes, we received this claim at [PII], and it was processed on [PII].
[AGENT][NEUTRAL] Claim number is 354-577-0.
[CUSTOMER][NEUTRAL] It's 354-577-0, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Thank you. And that's more than the claim?
[AGENT][NEUTRAL] Uh, one moment, please.
[CUSTOMER][NEUTRAL] Yes, sure.
[AGENT][NEUTRAL] OK, um, [PII], was this other claim for a different member or was this for the same under the same policy?
[CUSTOMER][NEUTRAL] Uh, it's a different number. Just give me a moment. I'm checking.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, one, right. Give me just a moment.
[CUSTOMER][POSITIVE] Yes, sir. Take your own time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Almost welcome.
[AGENT][NEUTRAL] OK, I'm ready for that next policy number when you are.
[CUSTOMER][NEUTRAL] Yeah. Uh, it's 02219206. M for Mary, L for Lima, 8.
[AGENT][NEUTRAL] Thank you. And uh what was the name and date of birth for this number?
[CUSTOMER][NEUTRAL] It's [PII], and the date of birth, [PII].
[AGENT][NEUTRAL] Thank you, what was the date of service, please?
[CUSTOMER][NEUTRAL] It's [PII] and the total charge $2,788 even.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Yes, sure.
[AGENT][NEUTRAL] [PII], I'm sorry, what was the name of the uh provider's office this was with?
[CUSTOMER][NEUTRAL] Yeah, it's Gastro Health LLC.
[AGENT][NEUTRAL] OK, I'm not showing that we received a claim uh for the state of service from Gastro Health.
[CUSTOMER][NEUTRAL] Like, it means there is no claim on file?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] Can you please provide the number effective date and termination date?
[AGENT][NEUTRAL] Yes, this policy's effective date was [PII].
[AGENT][NEUTRAL] And it did terminate [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Yeah. Thank you for, uh, thank you for giving this information. Have a nice day.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, is there anything else I can help you with?
[CUSTOMER][NEGATIVE] Uh, no thanks. That's it.
[AGENT][POSITIVE] Alright, well thanks for on ATL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Yeah, same to you. Bye-bye.
[AGENT][NEUTRAL] Bye bye.