AccountId: 011433970860
ContactId: edbb6f0f-4dd9-44c1-b495-dc11f1a29041
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 694700 ms
Total Talk Time (AGENT): 193365 ms
Total Talk Time (CUSTOMER): 143519 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/edbb6f0f-4dd9-44c1-b495-dc11f1a29041_20250328T18:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]
[AGENT][NEUTRAL] Hey [PII], how are you?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] I'm doing great how are you doing?
[AGENT][POSITIVE] Doing alright, thank you. What can we help you with today?
[CUSTOMER][NEUTRAL] I just need the status of some claims.
[AGENT][NEUTRAL] Sure, I can take those claims for you. Uh, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Alright, and were these claims going to be for the same member or were there multiple members we needed to check?
[CUSTOMER][NEUTRAL] Um, multiple members.
[AGENT][NEUTRAL] OK. Uh, you can go ahead and give me that first policy number.
[CUSTOMER][NEUTRAL] This is 01421986.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for this number?
[CUSTOMER][NEUTRAL] This is [PII], [PII].
[AGENT][NEUTRAL] OK, and then what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII], this is for 434.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] And I sure.
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] I just need the status of the 99214.
[AGENT][NEUTRAL] OK, so I will say that this policy terminated [PII], um, but I will, I can still check to see if we received this.
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] You said for 99214?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so yeah, of course, uh we were unable to pay benefit as the services were rendered after coverage was terminated.
[AGENT][NEUTRAL] Did you need a copy of this EOB or anything?
[CUSTOMER][NEUTRAL] Uh, no, I just need the denial day and a claim number.
[AGENT][NEUTRAL] Sure, so that claim number is 357-855-5.
[AGENT][NEUTRAL] And it was processed [PII].
[CUSTOMER][NEUTRAL] And can I have a reference number as well?
[AGENT][NEUTRAL] A reference number would be uh the same for all of them, so that would be my first name, last initial, and today's date. Uh, so my name is spelled [PII]
[CUSTOMER][POSITIVE] Perfect. Alright, we can move on to the next number.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm ready for that policy number when you are.
[CUSTOMER][NEUTRAL] This is 01640657.
[AGENT][NEUTRAL] OK, and then the name and date of birth for this number?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you. OK, and what was the date of service for this one?
[CUSTOMER][NEUTRAL] This is [PII] that is for 368.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, so for this claim we were unable to pay a benefit as office visits are not covered under this policy.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And what was the denial date for this one?
[AGENT][NEUTRAL] That was processed [PII].
[CUSTOMER][NEUTRAL] And the claim number?
[AGENT][NEUTRAL] That is 3558809.
[CUSTOMER][NEUTRAL] OK, we can move on to the next number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This is 01640658.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for this number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK and then uh what was the state of service?
[CUSTOMER][NEUTRAL] This is.
[CUSTOMER][NEUTRAL] [PII] for 170.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[AGENT][NEGATIVE] OK, so this one's denial reason is the same office visits are not covered, so we were unable to pay that benefit.
[CUSTOMER][NEUTRAL] And when was this one denied on?
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][NEUTRAL] And the claim number?
[AGENT][NEUTRAL] That is 3558382.
[CUSTOMER][POSITIVE] Perfect and we can move on to the last number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This would be 021.
[CUSTOMER][NEUTRAL] 3377.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, um, I think we're missing a digit in there. I have 0213377.
[CUSTOMER][NEUTRAL] Uh, it should be 021.
[CUSTOMER][NEUTRAL] 23377.
[AGENT][NEUTRAL] 23. OK, I apologize one moment.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for this number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Did you have her date of birth?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and then what was the date of service please?
[CUSTOMER][NEUTRAL] This is.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] For 465.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, uh, so this one is the same as well, um, offices that they're not covered under this policy.
[CUSTOMER][NEUTRAL] When did that announce?
[AGENT][NEUTRAL] Let's see, we did receive a duplicate that original claim was processed [PII].
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And then the claim number?
[AGENT][NEUTRAL] That is 3558132.
[CUSTOMER][NEUTRAL] Yeah, and I also have one more claim for this number.
[AGENT][NEUTRAL] Oh, for the same number?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, what was that date of service?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] For 170.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEGATIVE] OK, this one is the same office says that they're not covered so we were unable to pay a benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that I'll do.
[AGENT][NEUTRAL] That was also [PII].
[CUSTOMER][NEUTRAL] My claim number?
[AGENT][NEUTRAL] 3558134.
[CUSTOMER][POSITIVE] Perfect. Alright, well thank you for helping me with these claims today.
[AGENT][NEUTRAL] Of course, yeah, was there anything else I can help you with?
[CUSTOMER][POSITIVE] Uh, no, ma'am, you have a wonderful day.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL you too thank you bye bye.
[CUSTOMER][NEUTRAL] Bye bye.