AccountId: 011433970860
ContactId: df71e1d0-af34-411a-a533-1bc312c4eed3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 395899 ms
Total Talk Time (AGENT): 95953 ms
Total Talk Time (CUSTOMER): 87299 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/df71e1d0-af34-411a-a533-1bc312c4eed3_20250121T17:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Can you please give me your callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII]. And it's a direct line?
[AGENT][POSITIVE] Thank you
[AGENT][POSITIVE] Thank you, [PII], I appreciate that. And then what is the patient's name?
[CUSTOMER][NEUTRAL] Yup. Uh, before that, I do apologize. I missed your name. Could you please provide me?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][POSITIVE] Thank you so much for that.
[CUSTOMER][NEUTRAL] Yeah. Do you need the member ID?
[AGENT][NEUTRAL] Um, the member's name, please?
[CUSTOMER][NEUTRAL] Yup. The member's name is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then what's [PII]'s policy number?
[CUSTOMER][NEUTRAL] It's 02466442.
[AGENT][NEUTRAL] OK, let me look up this policy real quick.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I'm gonna do.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the date of service for Ari?
[CUSTOMER][NEUTRAL] Yeah, the service for this one is [PII].
[AGENT][NEUTRAL] OK, and the charge amount?
[CUSTOMER][NEUTRAL] $452 even.
[AGENT][NEUTRAL] OK and then what is the name of the facility you're calling for [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's fast-paced Medical Clinic.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I pull that claim in for you and I'll be right back here, [PII].
[CUSTOMER][NEGATIVE] Yeah. You are on hold.
[AGENT][NEUTRAL] 2
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], this is [PII] back with you again. So I did find the claim, but the claim was denied because the insured was not eligible. The policy lapsed on [PII], so it's no longer active.
[CUSTOMER][NEUTRAL] OK. The policy was done on a
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Oh, may I have the claim denied date?
[AGENT][POSITIVE] Yes sir, look for that for you.
[AGENT][NEGATIVE] It was received on [PII] and it was processed and denied on the [PII].
[CUSTOMER][NEUTRAL] Uh, did you say the, it was denied on a
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, of [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yeah. Thank you so much for that. May I have the claim number?
[AGENT][NEUTRAL] Yes sir, number is 337743.
[CUSTOMER][NEUTRAL] Oh, could you please repeat one more time?
[AGENT][NEUTRAL] Yes, 353-774-3.
[CUSTOMER][POSITIVE] Thank you so much for the information, um.
[CUSTOMER][NEUTRAL] May I have the uh call reference for this call?
[AGENT][NEUTRAL] Yes, you can use my name and today's date.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] And uh do you have any other insurance information for this client?
[AGENT][NEUTRAL] No, sir.
[CUSTOMER][POSITIVE] OK. Yeah. Uh thank you so much for your assistance.
[CUSTOMER][POSITIVE] Sure. Have a wonderful day.
[AGENT][NEUTRAL] You're welcome, [PII].
[AGENT][POSITIVE] You too thank you thanks for calling APL bye bye sir.
[CUSTOMER][NEUTRAL] Yeah, bye bye.