AccountId: 011433970860
ContactId: ec5ce4b6-ffd1-46ed-bc60-df14be33862c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 375660 ms
Total Talk Time (AGENT): 124433 ms
Total Talk Time (CUSTOMER): 105319 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/ec5ce4b6-ffd1-46ed-bc60-df14be33862c_20250123T19:15_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Thank you. I'm looking for claim status.
[CUSTOMER][NEUTRAL] Calling from provider office.
[AGENT][NEUTRAL] Yeah, I can check a claim for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] spend
[CUSTOMER][NEUTRAL] Yes, callback number.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Uh, allow me a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 01813065.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] OK, thank you and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Uh, in your first name is last name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that [PII]. uh, what was the uh date of service for this claim?
[CUSTOMER][NEUTRAL] Date of services is [PII].
[AGENT][NEUTRAL] [PII] and uh what was the bill amount please?
[CUSTOMER][NEUTRAL] [PII] and charge amount is $513 even.
[AGENT][NEUTRAL] 5:13, OK.
[AGENT][NEUTRAL] Alright, bear with me just a moment.
[AGENT][NEUTRAL] I'm sorry, [PII], what was the name of the provider's office?
[CUSTOMER][NEUTRAL] [PII] and the Murray Oar Oncology and Retina INC.
[AGENT][POSITIVE] OK, thank you for verifying that. All right.
[AGENT][NEUTRAL] So I did find this claim, give me just a moment.
[CUSTOMER][POSITIVE] OK, OK, take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, OK, so we were excuse me, we were unable to pay a benefit as.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Their other their medical plan there other than basic major medical, uh, we're unable to pay those benefits. So for example if it was uh Tricare, Medicare or Medicaid, we would be unable to pay those benefits.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Well yeah.
[AGENT][NEUTRAL] If you'd like I can send you a copy of this EOB.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, can you hear me?
[CUSTOMER][NEUTRAL] Yes, uh, please, can you repeat?
[AGENT][NEGATIVE] Yes, so we were unable to pay a benefit as whoever they have as their major medical is not going to be what we consider a basic major medical plan so.
[AGENT][NEUTRAL] For example, we would not be able to cover Tricare, Medicare, or Medicaid.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Would you like me to send you a copy of the EOB?
[CUSTOMER][NEUTRAL] Yes, by fax, can you provide me by fax?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Of course, what's that fax number for you?
[CUSTOMER][NEUTRAL] Yes, our fax number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and when I just put this to your attention, [PII]?
[CUSTOMER][NEUTRAL] Yes, it's [PII]
[AGENT][POSITIVE] OK, yes, got it. All right.
[AGENT][POSITIVE] I will go ahead and get that sent to you now. Yes, go ahead.
[CUSTOMER][POSITIVE] Thank you. May I have your
[CUSTOMER][NEUTRAL] Call the
[AGENT][NEUTRAL] Yeah, reference number would just be my first name, last initial, and today's date and so my name is spelled [PII]
[AGENT][NEUTRAL] Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Uh, that's it for today. Please, can you repeat your name?
[AGENT][NEUTRAL] Did you need the um did you need the claim number?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Can you hear me?
[CUSTOMER][NEUTRAL] Yes, yes. Can you provide me claim number?
[AGENT][NEUTRAL] Yeah, the claim number is 3542612.
[CUSTOMER][NEUTRAL] OK, uh, one time, can you repeat your name and spell?
[AGENT][NEUTRAL] Sure, it's [PII]
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you very much.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. That's it for today. Have a nice day. Thank you.
[AGENT][POSITIVE] You too thank you bye bye.