AccountId: 011433970860
ContactId: c13a06fa-c4e5-479b-a394-f225f278a36c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218500 ms
Total Talk Time (AGENT): 95876 ms
Total Talk Time (CUSTOMER): 68658 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/c13a06fa-c4e5-479b-a394-f225f278a36c_20250409T17:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, my name is [PII]. I'm with First Health of the Carolinas calling to check the status of a claim, please.
[AGENT][NEUTRAL] Sure, I could check on that claim for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] D as in David 42510781
[AGENT][NEUTRAL] OK, so [PII], that's not one of our policy numbers that is through, uh, they're called 90 degree benefits. Um, if you'd like I can give you their information and transfer you to them, or if you have the member's social, I could search for them that way to see if we received a claim.
[CUSTOMER][NEUTRAL] OK, um, I'd like to do both, please. Uh, the social is [PII].
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] The social is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] And what was the name for the member?
[CUSTOMER][NEUTRAL] [PII]. Birthday is [PII].
[AGENT][POSITIVE] Perfect. OK, and this was for medical correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, alrighty, so I did find that policy. Uh, what was the date of service for this claim, please?
[CUSTOMER][NEGATIVE] Day of service was $142025269 even.
[AGENT][NEUTRAL] OK, I'm sorry, you did say that was [PII] correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, and what was the name of this provider's office?
[CUSTOMER][NEUTRAL] First Health of the Carolinas MCPC 8.
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII]. We were unable to pay a benefit as the policy went active. The effective date was [PII], so the services were rendered prior to the effective date.
[CUSTOMER][NEUTRAL] And you said it was uh it was effective starting [PII]?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, um, is there any way I can get the EOB?
[AGENT][NEUTRAL] Absolutely do you have a fax number?
[CUSTOMER][NEUTRAL] 910
[CUSTOMER][NEUTRAL] 2357913
[CUSTOMER][NEUTRAL] Attention [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm going to read that back to make sure I heard that correctly. That was [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Alrighty, yes, I will go ahead and get that sent to you. I should get you here in about 10 minutes or so. Uh, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Just a reference number.
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date. Uh so my name is spelled [PII]
[CUSTOMER][POSITIVE] OK, thank you so much. You have a good day.
[AGENT][POSITIVE] Alright, of course, thanks for appeal. You too. Bye-bye.
[CUSTOMER][POSITIVE] Good