AccountId: 011433970860
ContactId: c9691506-e525-4c59-9ea3-b3314ccf6f74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 153500 ms
Total Talk Time (AGENT): 41036 ms
Total Talk Time (CUSTOMER): 67554 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/c9691506-e525-4c59-9ea3-b3314ccf6f74_20250411T21:01_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling for provider's office to check on uh additional information on a claim that has been denied. And please inform this call will be monitored and recorded for the quality and training purposes.
[AGENT][NEUTRAL] office.
[AGENT][POSITIVE] Hi [PII], I'd be happy to assist um if I can get a good call back number for you?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], it's a direct line.
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Sure, the policy number is 022.
[CUSTOMER][NEUTRAL] 970
[CUSTOMER][NEUTRAL] 83
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] And what is um
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient name is
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII], I'm sorry, [PII].
[AGENT][NEUTRAL] OK, and the date of service?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And tax ID.
[CUSTOMER][NEUTRAL] Tax ID is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that information, and I do show the claim was denied because there was no active coverage at the time of service. It looks as though the policy lapsed on [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] All right. Does the member have uh uh I mean, when will the member become effective from?
[AGENT][NEUTRAL] Effective date was [PII].
[CUSTOMER][NEUTRAL] OK, got it. Thank you so much. So the policy terminated on [PII] and uh if the member have any other active coverage?
[AGENT][NEUTRAL] No.
[CUSTOMER][POSITIVE] Not active. OK, thank you so much.
[CUSTOMER][NEUTRAL] All right then, can I get a call reference on this one?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII] [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][POSITIVE] Normally, sir, that is all I have for today and uh thank you so much for your assistance.
[AGENT][POSITIVE] Thank you for calling APL have a good day.
[CUSTOMER][POSITIVE] Have a great day bye bye.
[AGENT][NEUTRAL] Bye