AccountId: 011433970860
ContactId: c1ca69ee-69e0-4b90-82c5-7acbed0e542a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 168339 ms
Total Talk Time (AGENT): 78446 ms
Total Talk Time (CUSTOMER): 44317 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/c1ca69ee-69e0-4b90-82c5-7acbed0e542a_20250131T14:24_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] Hey [PII], I was calling to see if I can um take claim status on a claim please.
[AGENT][POSITIVE] Sure, I'll be more than happy to help you with claim status. Are you the insured or you're calling with the provider or group?
[CUSTOMER][NEUTRAL] Provider
[AGENT][NEUTRAL] OK, may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII], um [PII].
[AGENT][NEUTRAL] Thank you for that, and [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] The policy number is 02537898.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you like me to check on?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] $1,147.58.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] East Alabama Medical Center.
[AGENT][NEUTRAL] Here it is. OK, hold on one moment, I just found it.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 3549305.
[AGENT][NEGATIVE] And also on [PII], the the claim was denied and I'm getting the denial reason. The policy does not provide benefits for vaccines or immunizations or the administration of injections.
[CUSTOMER][NEUTRAL] And you said the policy number is 354.
[CUSTOMER][NEUTRAL] 9305.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So she don't have coverage for vaccines.
[AGENT][NEUTRAL] Or yeah, vaccines or injections of any kind.
[CUSTOMER][NEUTRAL] Alright, what's the call reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name, which is [PII], first initial to my last name is [PII] and today's date.
[CUSTOMER][POSITIVE] Alright thank you so much, [PII].
[AGENT][POSITIVE] You're welcome, [PII]. Well, thanks for calling APL. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You too, bye.
[AGENT][POSITIVE] Thank you, bye bye.