AccountId: 011433970860
ContactId: f666481e-7cce-4ce7-be83-41cbb1b26a8a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 308859 ms
Total Talk Time (AGENT): 111102 ms
Total Talk Time (CUSTOMER): 110647 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/f666481e-7cce-4ce7-be83-41cbb1b26a8a_20250213T21:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah, hello. Hi, my name is [PII]. I'm calling from Vital MD Group holding LLC.
[AGENT][POSITIVE] Yes, ma'am. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, I'll call you for a claim status. Before I proceed, please inform.
[AGENT][POSITIVE] Yes, I can assist you
[CUSTOMER][NEUTRAL] Yeah, I'm calling for more information on your claim. Before I proceed, please be informed that this call is being recorded for quality and training purpose. Would you like us to continue the recording?
[AGENT][NEUTRAL] Yes, that's fine. Um, I can assist you with claim status. First, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Yeah, sure. Yeah. My name is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now, could I get a, a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. My callback number is [PII].
[AGENT][NEUTRAL] Thank you. Now I need the member's policy number, please.
[CUSTOMER][NEUTRAL] Yeah. The member's policy number is
[CUSTOMER][NEUTRAL] 01333275 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Can you please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yeah, first name is [PII] and last name is [PII]. And the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Now, I need the date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] Yeah. The date of service is [PII] and the bill amount is $353 even.
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK. Yes, ma'am. We received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number
[CUSTOMER][NEUTRAL] Uh, it's January, sorry, uh, when was it received? January?
[AGENT][NEUTRAL] The claim was received on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 353-0791.
[CUSTOMER][NEUTRAL] It's 353-079-1.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes, ma'am. That's the claim number.
[CUSTOMER][POSITIVE] Yeah, thank you so much and.
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII], and this policy expired on [PII]. That's why the claim denied.
[CUSTOMER][NEUTRAL] Uh, when was it effective?
[AGENT][NEUTRAL] The policy was effective on [PII].
[CUSTOMER][NEUTRAL] My
[CUSTOMER][NEUTRAL] And um
[AGENT][NEUTRAL] And it turned on [PII].
[CUSTOMER][NEUTRAL] Yeah, uh, could you, uh, could you tell me, uh, member have any other insurance?
[AGENT][NEUTRAL] No, ma'am. I'm not showing any other policies on file.
[CUSTOMER][POSITIVE] Yep thank you so much.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And yeah, could you provide me a call reference number?
[AGENT][NEUTRAL] Call reference is my name and today's date. My name is [PII]. It's spelled [PII]
[AGENT][NEUTRAL] My last initial is, yeah.
[CUSTOMER][NEUTRAL] Uh, sir, could, could you tell me again?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And my last initial is [PII].
[CUSTOMER][NEUTRAL] like me.
[CUSTOMER][POSITIVE] Yeah, thank you so much, [PII].
[AGENT][POSITIVE] Mm. Thank you. [PII], is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] Yeah, no thanks, uh, [PII], and thank you so much. You are very helpful for me.
[CUSTOMER][POSITIVE] And have a nice day, maybe.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL bye.
[CUSTOMER][POSITIVE] Yeah thank you bye bye.