AccountId: 011433970860
ContactId: c902127e-b716-430d-8f4e-207022070574
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 181960 ms
Total Talk Time (AGENT): 62024 ms
Total Talk Time (CUSTOMER): 60098 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/c902127e-b716-430d-8f4e-207022070574_20250513T16:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling about a claim. Um, I'm just trying to check to see if there's any patient responsibility for this denied claim.
[AGENT][NEUTRAL] OK, I can help you with the claim status, Ms. [PII]. Can I please get your callback number, ma'am, just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Of course it's a direct line it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Of course, so, um, member's name.
[CUSTOMER][NEUTRAL] Is for [PII]. Birthday is [PII].
[CUSTOMER][NEUTRAL] And policy number is 2,505,720.
[AGENT][NEUTRAL] OK, let me look her up real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright and you said that the claim has already been denied, do you have the claim number?
[CUSTOMER][NEUTRAL] I do. That number is 359-570-9. The date of service is [PII].
[AGENT][NEUTRAL] OK, let me look up that claim number real quick for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and I do see that the claim was denied because the policy only provides benefits for the treatment of um sickness or injury, and we do not give patient responsibility. We allow for the provider to determine that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, if this if it's not covered, OK.
[CUSTOMER][NEUTRAL] I have no idea um.
[CUSTOMER][NEUTRAL] OK, and, uh, I'm sorry, what, what did you say your name was?
[AGENT][NEUTRAL] My name is [PII], it's [PII]
[CUSTOMER][POSITIVE] OK beautiful and I would just take a reference number for the call please.
[AGENT][NEUTRAL] Yes, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] Beautiful thank you so much for the time you have a great day.
[AGENT][POSITIVE] You have a wonderful day too, Ms. [PII], and thank you for calling APL.
[AGENT][NEUTRAL] Bye bye, ma'am.
[CUSTOMER][POSITIVE] Thank you. Goodbye.