AccountId: 011433970860
ContactId: de99e27e-46a5-4d12-ac28-8db8971fba85
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 401510 ms
Total Talk Time (AGENT): 111996 ms
Total Talk Time (CUSTOMER): 150350 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/de99e27e-46a5-4d12-ac28-8db8971fba85_20250110T13:35_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office checking on claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status. And did you say your name is [PII]?
[CUSTOMER][NEUTRAL] It is [PII]
[AGENT][NEUTRAL] In in case this call is disconnected, may I have your callback number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The callback number is [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, uh, just one moment.
[CUSTOMER][NEUTRAL] One moment, please. Do it slow.
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes, yes, um.
[CUSTOMER][NEUTRAL] One.
[CUSTOMER][NEUTRAL] And was
[CUSTOMER][NEUTRAL] Yes, the policy ID is 1551242.
[AGENT][NEUTRAL] Thank you, and that number was 1551242?
[CUSTOMER][NEUTRAL] That's
[AGENT][NEUTRAL] Thank you. And may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's uh full name is uh [PII], and the date of birth is, it's a newborn, [PII].
[AGENT][NEUTRAL] And what was the date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] The date of birth is [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] I got another.
[AGENT][NEUTRAL] And could you please repeat the patient's first name?
[CUSTOMER][NEUTRAL] Yes, sir. Patient's first name is [PII]. It is [PII], [PII], and last name is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, under this coverage, I show this is individual coverage. I do not show [PII] is covered under this particular policy.
[CUSTOMER][NEUTRAL] OK. Could you please check with the mother's one?
[AGENT][NEUTRAL] This is, that's the policy number that you gave me, which is the policyholder, and she is not covered. This is only individual coverage.
[CUSTOMER][NEUTRAL] OK. So, this [PII]?
[AGENT][NEGATIVE] It's not family coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, did you receive any claim?
[AGENT][NEUTRAL] We have no claim on file.
[CUSTOMER][NEUTRAL] Are you able to pull the [PII] Destiny number?
[AGENT][NEUTRAL] I'm sorry, can you repeat that?
[CUSTOMER][NEUTRAL] Are you able to pull the details of the [PII] Destiny?
[AGENT][NEUTRAL] [PII] is not under the policy number that you gave me. I could try to pull her by a different, I mean by her name, but if.
[AGENT][NEUTRAL] Unless she has her own coverage other than her, her, the policy member.
[CUSTOMER][NEUTRAL] OK. So the policy number.
[AGENT][NEUTRAL] Do you have a different policy number?
[CUSTOMER][NEUTRAL] Uh, no, the policy number is um related to [PII], [PII].
[AGENT][NEUTRAL] What's the spelling of [PII]'s name?
[AGENT][NEUTRAL] As it spelled.
[CUSTOMER][NEUTRAL] To these
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm not showing any coverage for her in our system.
[CUSTOMER][NEUTRAL] OK. So the policy number which I gave you.
[CUSTOMER][NEUTRAL] Is showing other name than the farmer's destiny.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] So I just want to verify whether that name is related to [PII] Santaria.
[AGENT][NEUTRAL] Yes, that's the policyholder. She only has individual coverage, no family coverage.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So the baby cannot be added, right?
[AGENT][NEUTRAL] Is this for newborn services?
[CUSTOMER][NEUTRAL] Yes, it is, uh, it is the newborn, newborn one. So, will the baby can be covered under mother's policy?
[CUSTOMER][NEUTRAL] 41
[AGENT][NEUTRAL] Yes, they'll need to notify us of adding the newborn to the coverage. I don't show that we have a claim on file for her, for Destiny.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] OK. So, is the time is there in order to add the baby?
[AGENT][NEUTRAL] This policy termed in [PII]. This policy is no longer active.
[AGENT][NEUTRAL] I show no other active coverage with us.
[CUSTOMER][NEUTRAL] OK, can.
[CUSTOMER][NEUTRAL] Can I have the effective date and the termination date?
[AGENT][NEUTRAL] Sure, the effective date [PII], term [PII].
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] The coverage is not um active for the date of service, right?
[AGENT][NEUTRAL] Correct, they no longer have coverage.
[CUSTOMER][NEUTRAL] OK. Um, is the mother have any other policies from your end, are you able to see?
[AGENT][NEUTRAL] No, there's no active coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, nothing else. Thank you so much.
[AGENT][POSITIVE] OK, you're welcome. Thanks for calling APL. You have a good day. bye.
[CUSTOMER][NEUTRAL] We have the