AccountId: 011433970860
ContactId: ef911285-394b-4219-a65a-323e322ecc4b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163679 ms
Total Talk Time (AGENT): 61798 ms
Total Talk Time (CUSTOMER): 52577 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/ef911285-394b-4219-a65a-323e322ecc4b_20250516T18:56_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I'm calling from Heron Hospital and I need to check claim status.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the claim status. [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII]. My extension is [PII].
[CUSTOMER][NEUTRAL] And policy number is 02556849.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Birthday [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] Data service is [PII] for $3,745.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Heron, H E R R I N, Hospital.
[AGENT][NEUTRAL] Alright, here we go, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, so I'm showing the claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 354.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 1025.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[AGENT][NEUTRAL] Because it's not a covered place of service, the policy um covers treatment by a physician or covered sickness in a physician's office, clinic, urgent care, or emergency room.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, do you have a reference number for this call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] All right. Thank you very much. You have a good day.
[AGENT][POSITIVE] Thank you, you also, [PII] and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.