AccountId: 011433970860
ContactId: ce1e757c-71b9-49a9-98ea-4ddc144f0926
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 306760 ms
Total Talk Time (AGENT): 129182 ms
Total Talk Time (CUSTOMER): 58054 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/ce1e757c-71b9-49a9-98ea-4ddc144f0926_20250625T18:24_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] here, looking for the claim status from New York University. How are you doing today?
[AGENT][NEUTRAL] OK, you're needing, I'm doing fine. And did you say that your name is [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] E.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yeah, that's right, yeah.
[AGENT][NEUTRAL] OK, thank you. And [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Uh-huh, yes.
[AGENT][POSITIVE] Yes, I can help you with that. [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the members, uh, do you just have one claim, [PII]?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, and what is that member's policy number, please?
[CUSTOMER][NEUTRAL] 025
[CUSTOMER][NEUTRAL] 96755.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] One moment please.
[CUSTOMER][NEUTRAL] By the way, can you spell your name for my recommendation?
[AGENT][NEUTRAL] My name is [PII] and it is spelled [PII] I.
[CUSTOMER][POSITIVE] Thank you, w. Yeah, you can check now.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, just one moment while I'm getting the member's information pulled up.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And any information, [PII] that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII]. [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount, please.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, [PII] with $25 even.
[AGENT][NEUTRAL] OK, so data service is 3202025 for $25 is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And what is the provider's name again, the facility?
[CUSTOMER][NEUTRAL] New York University.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so I do show that this claim was received, [PII], the received date was 51 and it was processed and denied on the same date.
[AGENT][NEUTRAL] The claim number is 359-621-9.
[AGENT][NEUTRAL] And the denial remarks.
[AGENT][NEUTRAL] On here state this policy does not provide a wellness expense benefit.
[AGENT][NEUTRAL] And the other remarks states that veena puncture is not covered by this policy.
[CUSTOMER][NEUTRAL] By the patient's plan or provided the contract?
[AGENT][NEUTRAL] Patient plan.
[AGENT][NEUTRAL] And [PII], if you need a copy of this explanation of benefits, you should be able to print it by using that claim number that I gave you if you go to our portal website which is located at [PII].
[CUSTOMER][NEUTRAL] Are you sure?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, yeah
[CUSTOMER][NEUTRAL] Can I get the call reference number?
[AGENT][NEUTRAL] The same it would be my name along with today's date.
[AGENT][NEUTRAL] And is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, no, I see, that's it for the call. Bye for now.
[AGENT][POSITIVE] OK. Well, well, thank you for calling APL and I hope you have a nice rest of your day.
[CUSTOMER][POSITIVE] You too. Bye. Take care.
[AGENT][POSITIVE] Thank you. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Bye