AccountId: 011433970860
ContactId: f05f166b-8a84-4e62-a5b4-64761c0f0c5e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167250 ms
Total Talk Time (AGENT): 41712 ms
Total Talk Time (CUSTOMER): 56794 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/f05f166b-8a84-4e62-a5b4-64761c0f0c5e_20250116T21:15_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm [PII] calling you from the provider's office to check on your claim status.
[AGENT][POSITIVE] I'd be happy to assist with claim status today [PII] if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] So, before proceeding further, I would like to inform you that this call is getting recorded for quality and training purposes. Number is 02480044.
[AGENT][NEUTRAL] I'm sorry, repeat that policy number for me.
[CUSTOMER][NEUTRAL] Yes, 02480044.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And the date of service for the claim?
[CUSTOMER][NEUTRAL] [PII] with $5,602 even.
[AGENT][NEUTRAL] And your tax ID?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you for that information.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm showing that the claim was denied because it the date of service was prior to the effective date of coverage.
[CUSTOMER][NEUTRAL] OK, may I know when did the members coverage started?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] All right, thank you so much and before that the member did not have any other policy?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] Perfect. Thank you so much for that information, [PII]. May I know the claim number?
[AGENT][NEUTRAL] Claim number is 354-538-2.
[CUSTOMER][NEUTRAL] All right, can I get the call reference?
[AGENT][NEUTRAL] Reference is just named [PII] last initial S as in [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] No, that's all for today, [PII]. Thank you so much for the assistance. Have a wonderful day. Bye bye.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.