AccountId: 011433970860
ContactId: e3189f10-ab0e-42d1-a2d6-a0b6c14198cc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243559 ms
Total Talk Time (AGENT): 77005 ms
Total Talk Time (CUSTOMER): 88614 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/e3189f10-ab0e-42d1-a2d6-a0b6c14198cc_20250313T14:10_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you
[AGENT][NEUTRAL] For calling APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling in regards to claim status.
[AGENT][NEUTRAL] Sure, I can check a claim for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, [PII], are you with a provider?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] OK, uh, can I get a good call back number from you in case we're disconnected?
[AGENT][NEUTRAL] Please
[CUSTOMER][NEUTRAL] Yep [PII].
[AGENT][NEUTRAL] OK, thank you. And then did you have the policy number?
[CUSTOMER][NEUTRAL] Um, yes, I do. It's 02369605 ML 8.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] [PII] and then [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that [PII]. uh, what was the date of service?
[AGENT][NEUTRAL] For this claim please.
[CUSTOMER][NEUTRAL] Um, [PII] for $160.
[AGENT][NEUTRAL] OK thank you one moment please.
[AGENT][NEUTRAL] I'm sorry [PII], what was the name of the provider's office you were with?
[CUSTOMER][NEUTRAL] The Cardenist and the alone huh.
[AGENT][NEUTRAL] Do you happen to have that tax ID by chance?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Alright, so we did receive this claim, uh, we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK, what is the claim number?
[AGENT][NEUTRAL] Sure, that's 34.
[AGENT][NEUTRAL] 653-06.
[CUSTOMER][NEUTRAL] OK, so it's just just those numbers?
[AGENT][NEUTRAL] Yes, yes, that's the full claim number.
[CUSTOMER][NEUTRAL] OK, I'm, I'm trying to see if I can pull it up on the portal. Just give me a second.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] If you need the EOB I can send that to you.
[CUSTOMER][POSITIVE] Yes, that'd be great, um.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Oh, actually I was able to pull it up on the portal now that you gave me the claim number. Let me see if just if it gives the information I need.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, but you said um they didn't pay the the copay because it's just not part of their plan, right?
[AGENT][NEGATIVE] Yeah, office visits just aren't covered under this policy, so we were unable to pay that benefit.
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] Covered under this policy, OK.
[CUSTOMER][NEUTRAL] Um, let me see, did it download?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, I think I, I think I got the EOB now, um, so thank you so much. I just need a call reference number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] last initial is [PII] Was there anything else I could help you with?
[CUSTOMER][POSITIVE] No, that's all thank you.
[AGENT][POSITIVE] OK, yeah, thanks for APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thanks bye bye.