AccountId: 011433970860
ContactId: d5cd1806-cb5a-495d-8afe-4241064d35e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 273929 ms
Total Talk Time (AGENT): 92418 ms
Total Talk Time (CUSTOMER): 151864 ms
Interruptions: 3
Overall Sentiment: AGENT=0.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/d5cd1806-cb5a-495d-8afe-4241064d35e8_20250610T20:17_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. My name is [PII].
[CUSTOMER][POSITIVE] Good afternoon. Thank you for calling. My name is [PII].
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and you said my last name is [PII] calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, well, I'll be more than happy to help you with the claim status, [PII]. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] They help you with the claim status, [PII].
[CUSTOMER][NEUTRAL] 73 today. I have one.
[AGENT][NEUTRAL] Alright, and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Alright, I have a good contact number in case we disconnected. [PII] and [PII].
[AGENT][NEUTRAL] Thank you. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, um, one moment.
[CUSTOMER][NEUTRAL] Policy number, um it's 02536444.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] And can you verify the member's first and last name and date of birth? Yes, member's name is [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim?
[CUSTOMER][POSITIVE] Thank you all the information provided.
[CUSTOMER][NEUTRAL] Yes, state of service is [PII]. Total bill $34 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEGATIVE] I don't wanna call.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Do you mean by the name of the
[CUSTOMER][NEUTRAL] on the plane.
[CUSTOMER][NEUTRAL] Yes, provider's name is Cleveland Clinic Foundation.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] I'm showing the claim was received on [PII].
[CUSTOMER][NEUTRAL] So the claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 354.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] My number is 354.
[AGENT][NEUTRAL] 0166.
[CUSTOMER][NEUTRAL] 0166.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[CUSTOMER][NEUTRAL] [PII], the claim was denied.
[AGENT][NEGATIVE] Because mini puncture is not a covered, is not covered by this policy.
[CUSTOMER][NEGATIVE] Because mini puncture is not covered, is not covered by this policy.
[CUSTOMER][NEUTRAL] I'm sorry, what was that again?
[AGENT][NEGATIVE] Vinny puncture is not covered by this policy.
[CUSTOMER][NEGATIVE] Then puncture is not.
[CUSTOMER][NEUTRAL] Policy.
[CUSTOMER][NEUTRAL] OK, so can we be patient?
[AGENT][NEUTRAL] Um, we don't determine patient responsibility, so the remaining or outstanding balance, uh, would be up to you as a provider to determine.
[CUSTOMER][NEUTRAL] Um, we don't determine patient responsibility, so the remaining outstanding balance, uh would be up to you as a provider to determine.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK, thank you for that information.
[AGENT][POSITIVE] You're very welcome, sir.
[CUSTOMER][NEUTRAL] You said mini puncture, right? You, I'm sorry, you said mini puncture, right? M I N I B U N C T U R E, is that correct?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] V like Victor, E like elephant, N like Nancy.
[CUSTOMER][NEUTRAL] V like Victor. E like elephant, N like Nancy.
[AGENT][POSITIVE] I like igloo,
[AGENT][NEUTRAL] P like Paul, U umbrella, N Nancy, C Charlie, T Tom.
[CUSTOMER][POSITIVE] I like igloo.
[CUSTOMER][NEUTRAL] P like
[CUSTOMER][NEUTRAL] U umbrella, N Nancy, C Charlie, T Tom.
[AGENT][NEUTRAL] U umbrella.
[AGENT][NEUTRAL] R Robert.
[CUSTOMER][NEUTRAL] You umbrella.
[AGENT][NEUTRAL] E elephant.
[CUSTOMER][NEUTRAL] R Robert.
[CUSTOMER][NEUTRAL] OK, Venny puncture, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, thank you so much. um, that will be all for today, [PII], um, can I have a call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date.
[CUSTOMER][NEUTRAL] There's no call reference number, but you can use the name of today's date.
[CUSTOMER][POSITIVE] Thank you, [PII]. Have a wonderful day. Bye.
[AGENT][POSITIVE] You also, [PII], thanks for calling APO. Bye-bye.
[CUSTOMER][POSITIVE] You're welcome sir thanks for calling. Bye-bye.