AccountId: 011433970860
ContactId: d563c181-f731-4ebc-b0cf-bef11f59609d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 181039 ms
Total Talk Time (AGENT): 80908 ms
Total Talk Time (CUSTOMER): 55076 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/d563c181-f731-4ebc-b0cf-bef11f59609d_20250404T17:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi. This is uh. I'm calling from provider office. I need one claim status from you.
[AGENT][NEUTRAL] I can verify claim status. May I have a policy number?
[CUSTOMER][NEUTRAL] So I have member ID. Can I go ahead?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] 02572273.
[AGENT][NEUTRAL] [PII], may I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] I have [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, the patient is [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] That date of birth does not match.
[AGENT][NEUTRAL] Who would be the claim for?
[CUSTOMER][NEUTRAL] OK. So, one second, yeah, yeah. OK, OK. OK. So that is [PII]. Sorry.
[AGENT][NEUTRAL] OK, thank you for verifying that information. May I have the date of service?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Total bill amount?
[CUSTOMER][NEUTRAL] $1,482.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] to check claim status as well. This processed under claim number 3565893. Looks like no benefits were payable on this claim. This claim was received on [PII]. It denied on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And it denied because.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This plan is for accident treatment only.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, treatment due to a sickness is not covered under this policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, actually, no. Uh, I only need this information. Thank you so much. Uh, do you have any reference number for this call?
[AGENT][NEUTRAL] It will be my name, which is [PII] Last initial is [PII] along with today's date.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Thank you.
[AGENT][POSITIVE] So, you're so welcome and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] You too. Bye.