AccountId: 011433970860
ContactId: c8dfceb0-1b7e-4a0c-926f-97531142a5ac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219619 ms
Total Talk Time (AGENT): 70372 ms
Total Talk Time (CUSTOMER): 160435 ms
Interruptions: 7
Overall Sentiment: AGENT=0.7, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/c8dfceb0-1b7e-4a0c-926f-97531142a5ac_20250228T13:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you? Hi, my name is [PII]. It spelled as [PII], and the last name initial is [PII], and I'm calling from provider office.
[AGENT][NEUTRAL] And your
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. I'm checking on claim status and I do apologize I didn't get your name. May I have your name again?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] It's [PII] All right, thank you [PII]. First initial last name is [PII]
[AGENT][NEUTRAL] First initial last name is [PII]
[AGENT][NEUTRAL] And you'll use my name and today's date as reference for today's call and you pronounce your first name is it [PII]?
[CUSTOMER][POSITIVE] Thank you. And you'll use my name and today's date as reference for today's call and you pronounce your first name is it [PII]? That's right.
[AGENT][NEUTRAL] OK, and you're checking claim status?
[CUSTOMER][NEUTRAL] OK, and you're checking claim status? Right.
[AGENT][NEUTRAL] OK, we can help you with that information. What's the policy number and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK, we can help you with that information. What's the policy number and a good phone number in case we're disconnected? OK, let me provide the callback number that is [PII] and the extension is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the member ID number is 01991586 M as in Maria, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Thank you verify the patient's name and date of birth, please? Sure. This is [PII] and the last name is spelled like [PII]
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][POSITIVE] Thank you for that information and your if you can provide the date of service and the total bill amount.
[CUSTOMER][NEUTRAL] Thank you for that information and your, if you can provide the date of service and the total bill amount. OK, [PII] bill amount is $146.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Showing this claim was received [PII], processed on [PII]. Uh, no payment was made as this service is not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Showing this claim was received [PII], processed on [PII]. Uh, no payment was made as this service is not covered under the patient's policy. OK. So may I know what kind of a policy, this is medical policy, or something else?
[AGENT][NEUTRAL] It's a supplemental, it's a GAT policy, a MetLink policy, which is secondary to the major medical plan.
[CUSTOMER][NEUTRAL] It's a supplemental, it's a gap policy, a Metlink policy, which is secondary to the major medical plan.
[CUSTOMER][NEUTRAL] OK, and may I have the claim number?
[AGENT][NEUTRAL] That claim number is 351-0038. And did you have any other questions [PII] I can assist with today?
[CUSTOMER][NEUTRAL] That claim number is 351-0038 and did you have any other questions for it I can assist with today? Yes, uh, we also send the appeal on this, so did you receive any appeals for this claim?
[AGENT][NEUTRAL] When was it submitted?
[CUSTOMER][NEUTRAL] When was it submitted? It was submitted on [PII].
[AGENT][NEGATIVE] I do not show it received.
[CUSTOMER][NEGATIVE] I do not show it received.
[CUSTOMER][NEUTRAL] OK. All right, thank you. And I do apologize, can you repeat the claim number one more time?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I'm sorry. The claim number, may I have the claim number again?
[AGENT][NEUTRAL] OK, can you repeat what you wrote down and I can confirm.
[CUSTOMER][NEUTRAL] OK, can you repeat what you wrote down? then I can confirm I don't have the claim number. I just missed out.
[AGENT][NEUTRAL] 351-003-8
[CUSTOMER][NEUTRAL] 351-003-8
[CUSTOMER][POSITIVE] All right. All right, so thank you. That's all for today. Have a nice day. Bye-bye.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL Roy. Have a good day as well.
[CUSTOMER][POSITIVE] You're welcome. Thanks for calling APL Roy. Have a good day as well.