AccountId: 011433970860
ContactId: e39f587e-7721-4392-a405-68c847f68f53
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210759 ms
Total Talk Time (AGENT): 65147 ms
Total Talk Time (CUSTOMER): 58576 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/e39f587e-7721-4392-a405-68c847f68f53_20250313T17:12_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, uh, good morning, [PII]. This is [PII], and I'm calling on behalf of Acumen. So please be advised that this call is recorded for monitoring purpose. Um, I just need to check, um, a claim.
[AGENT][POSITIVE] OK, [PII]. I'm happy to check a claim for you today. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, 14.
[CUSTOMER][NEUTRAL] 63
[CUSTOMER][NEUTRAL] 23
[CUSTOMER][NEUTRAL] 1
[CUSTOMER][NEUTRAL] M as in Mary, L for Lima, number 8.
[AGENT][POSITIVE] Thank you for that. And do you have a good callback number?
[CUSTOMER][NEUTRAL] Mhm. Callback number [PII] direct.
[AGENT][NEUTRAL] Thank you. And patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][NEUTRAL] Thank you. And then what's the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] In the bill amount?
[CUSTOMER][NEUTRAL] $2,241.
[AGENT][NEUTRAL] OK. One moment, let me take a look.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] Right, so it looks like we did [PII] receive a claim for this date of service. Looks like the claim was received [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Claim was denied. Services were rendered after the policy was effective, so patient wasn't active at the time of service.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] Mm, um, may I know when is the member term or the range of eligibility?
[AGENT][NEUTRAL] The effective date was [PII].
[AGENT][NEUTRAL] The policy terminated on [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you. Um, uh, yeah, actually, sorry, that's all that I need. Um,
[CUSTOMER][NEUTRAL] Do you have a reference number?
[AGENT][NEUTRAL] Call reference would be my name with my last initial than today's date. My name again is [PII], that's [PII], last initial [PII].
[CUSTOMER][POSITIVE] Thank you. Alright, uh thank you for having me on the line, [PII]. Enjoy the rest of the day and bye for now.
[AGENT][POSITIVE] Have a good one. Bye bye.