AccountId: 011433970860
ContactId: c0ef69d2-5f57-4a5e-817f-6a4c5239112d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215630 ms
Total Talk Time (AGENT): 69433 ms
Total Talk Time (CUSTOMER): 56020 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/c0ef69d2-5f57-4a5e-817f-6a4c5239112d_20250327T14:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was calling about claim status.
[AGENT][NEUTRAL] OK, can I get your name and a good callback number?
[CUSTOMER][NEUTRAL] And your legs
[CUSTOMER][NEUTRAL] Yes, [PII]
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], your last name initial?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, [PII], and it's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, [PII], do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Uh, I do. It would be 5994.
[CUSTOMER][NEUTRAL] 35.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII] or [PII].
[AGENT][NEUTRAL] And you said claim status, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what was that data service?
[CUSTOMER][NEUTRAL] It will be 11:25 or 24.
[CUSTOMER][NEUTRAL] $3,727.
[AGENT][NEUTRAL] OK, let's see uh.
[AGENT][NEUTRAL] Pulling that up.
[AGENT][NEUTRAL] And it looks like it was a non-covered place of service under the writer of the policy, um.
[AGENT][NEUTRAL] Uh, covers treatment by a physician for a covered sickness in the physician's office, clinic, urgent care facility, or emergency room.
[AGENT][NEUTRAL] And then according to the information on file we were not, it was not rendered in a covered place of service therefore, no benefits were payable.
[CUSTOMER][NEUTRAL] So, OK, so it dropped down to the patient.
[AGENT][NEUTRAL] Um, we don't determine patient responsibility, um, as we're a secondary policy.
[AGENT][NEUTRAL] We just process according to their plan.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] You said it was not covered under the member's plan?
[AGENT][NEUTRAL] Yes, correct. It was a non-covered benefit based on the place of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because the policy they have is like a 2nd or supplemental policy.
[CUSTOMER][NEUTRAL] Based on
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get the EOB?
[AGENT][NEUTRAL] Uh, sure. Do you want me to fax it to you?
[CUSTOMER][NEUTRAL] Um, can you email it?
[AGENT][NEUTRAL] Uh, no, I can't email.
[CUSTOMER][NEUTRAL] OK, yes, fax number would be [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Attention [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And is there anything else I can help with today, [PII]?
[CUSTOMER][NEUTRAL] No, that'll be all. Can I get a reference?
[AGENT][NEUTRAL] Uh, reference just my first name, last initial, and today's date.
[CUSTOMER][POSITIVE] OK, thanks so much.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye.