AccountId: 011433970860
ContactId: b62fec88-1bf8-40ad-bdc0-a595ee5da449
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166639 ms
Total Talk Time (AGENT): 78228 ms
Total Talk Time (CUSTOMER): 54150 ms
Interruptions: 0
Overall Sentiment: AGENT=2.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/b62fec88-1bf8-40ad-bdc0-a595ee5da449_20250226T14:19_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, this is [PII] calling to provide our office to check on additional information about a claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you, [PII]. What is the policy number for the patient?
[CUSTOMER][NEUTRAL] The policy ID I have it.
[CUSTOMER][NEUTRAL] 02129203. M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you. And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right. Thank you.
[AGENT][POSITIVE] And it would be my pleasure to assist you with that claim information. Do you happen to have the claim number or date of service?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Claim number 3559788.
[AGENT][NEUTRAL] Thank you [PII]. What is the data service build amount and facility name?
[CUSTOMER][NEUTRAL] The service from [PII] and the facility name is Saba Medical Group.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] I am showing that we did receive that claim on [PII] and was processed and denied on [PII], denied as services were rendered after the policy termed. This policy termed on 3-1-2024.
[CUSTOMER][NEUTRAL] And policy effective from?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Do you have any other insurance with active?
[AGENT][NEUTRAL] Not with APL you would need to contact the patient to see if he had active coverage for that data service under another provider.
[CUSTOMER][NEUTRAL] Can I get the reference number?
[AGENT][NEUTRAL] The reference number is my name and today's date, and I spell my name A L I C I A. First initial last name L as in Lima.
[AGENT][POSITIVE] And it was a pleasure to assist you with that claim information. Anything else I can help you with, [PII]?
[CUSTOMER][POSITIVE] No, that's it for the day and thank you so much for then, sir. I wish you have a great day. Bye.
[AGENT][POSITIVE] I hope you have a wonderful day as well.