AccountId: 011433970860
ContactId: cb97bf21-40af-4102-ade3-8eda1668c70e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 199639 ms
Total Talk Time (AGENT): 69359 ms
Total Talk Time (CUSTOMER): 69387 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/cb97bf21-40af-4102-ade3-8eda1668c70e_20250213T14:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, uh, good morning. My name is [PII] and last term initial [PII]. I'm calling from provider's office regarding the claim status.
[AGENT][NEUTRAL] Have you received the claim and you need clarification or is this the initial?
[AGENT][NEUTRAL] Status.
[CUSTOMER][NEUTRAL] Sorry? Yeah, uh, I need the initial claim status, like general claim status.
[AGENT][NEUTRAL] Are you checking claim status or do you need clarification on a claim?
[CUSTOMER][NEUTRAL] No, no, I need a claim status.
[AGENT][NEUTRAL] OK. And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Yeah, sure. Just give me a moment. It's loading.
[CUSTOMER][NEUTRAL] One second. OK. Uh, it's 1146789.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. [PII]. It is a direct line.
[AGENT][NEUTRAL] OK, and what's the date of service and the charge?
[CUSTOMER][NEUTRAL] OK. Um, the date of service is [PII] and the total charge is $237 even.
[AGENT][POSITIVE] OK thank you give me a moment to pull up the file and then we'll be able to help you.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK, so no payment was made on this claim. Uh, the date of service is after the termination date. Um, the claim number associated with this date of service is 354.
[AGENT][NEUTRAL] 2761.
[AGENT][NEUTRAL] This claim was received [PII], processed [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the denial reason?
[AGENT][NEUTRAL] The date of services after the policy termination date.
[AGENT][NEUTRAL] The policy termination date is [PII].
[CUSTOMER][NEUTRAL] The policies in that.
[AGENT][NEUTRAL] Effective date is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]. So Active 1 [PII] and uh uh terminated on [PII], right?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][POSITIVE] OK, thank you so much. So member have any other instances?
[AGENT][NEUTRAL] No other policies with APL.
[CUSTOMER][NEUTRAL] OK. Thank you. And can you please spell your name?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference [PII], first initial last name is [PII]. Anything else I can help out with today?
[CUSTOMER][POSITIVE] Uh, no, [PII]. That's it. Thank you and thank you for giving this information. Have a nice day.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah.