AccountId: 011433970860
ContactId: f6aa3eca-0b62-4a29-b6ad-ad7075691fcf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 490779 ms
Total Talk Time (AGENT): 178503 ms
Total Talk Time (CUSTOMER): 90772 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/f6aa3eca-0b62-4a29-b6ad-ad7075691fcf_20250410T12:25_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, my name is [PII]. I'm calling from providerzone first to check on the client status.
[AGENT][NEUTRAL] OK, [PII], did you say that you were needing to check claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. And the extension is [PII]?
[AGENT][NEUTRAL] Thank you. And how many claims [PII], do you have to check status on today?
[CUSTOMER][NEUTRAL] Uh, I have just 11 thing.
[AGENT][NEUTRAL] One claim? OK, yes ma'am, I can help you. And what is your call, I'm sorry, what is the patient's policy number, please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, 018.
[CUSTOMER][NEUTRAL] 792
[CUSTOMER][NEUTRAL] 85
[CUSTOMER][NEUTRAL] M as in Mike. L as in Lima, 8.
[AGENT][NEUTRAL] OK, thank you, [PII]. One moment while I get all of the members' information pulled up please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information that is provided today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Everything is about.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for him please?
[CUSTOMER][NEUTRAL] Date of service is [PII] and the total amount, $193 even. It's 193.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK [PII] so this claim was received on [PII].
[AGENT][NEUTRAL] 25.
[AGENT][NEUTRAL] It was processed and denied on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is going to be 356.
[AGENT][NEUTRAL] 623-7.
[AGENT][NEUTRAL] And the denial remark on this claim states.
[AGENT][NEUTRAL] Benefits are
[AGENT][NEUTRAL] Payable under this certificate or limited lined in the schedule of benefits. This is not a covered loss under the plan. Therefore, no amount is payable for this expense.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEGATIVE] This is not covered under the patient's plan.
[CUSTOMER][NEUTRAL] I'm sorry, can you please repeat again?
[AGENT][NEUTRAL] Ma'am.
[CUSTOMER][NEUTRAL] Not
[CUSTOMER][NEUTRAL] It's not covered under the patient plan, am I right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. And can you please send me the ID a little fax?
[AGENT][NEUTRAL] I can give you our portal website, [PII], where you can actually print that now that you have the claim number.
[CUSTOMER][NEUTRAL] Yes. Uh, you can send the fax.
[AGENT][NEUTRAL] Are you able to print?
[CUSTOMER][NEUTRAL] No, ma'am. Can you send me a bit of fax?
[AGENT][NEUTRAL] OK, so you're not able to print from a website, is that correct? from our portal?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] It's still loading the information, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if for any reason you do not receive it, the um other option would be go to [PII] and use that claim number to print it.
[CUSTOMER][NEUTRAL] OK, can I get the fax number?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] In just one moment, I will, as soon as my information loads, I will provide, I will get that fax number from you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Does it need to be put to your attention, the facts?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what's your fax number please, [PII]?
[CUSTOMER][NEUTRAL] Yes, I have fax number uh.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 407
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 0047.
[AGENT][NEUTRAL] OK, again, that was
[AGENT][NEUTRAL] Excuse me. [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, [PII], so that explanation has been has been faxed to you, so provided that there's not any type of issue with you being able to receive it, you should be receiving receiving it very soon.
[CUSTOMER][NEUTRAL] OK, may I know your name and the call reference?
[AGENT][NEUTRAL] And is there anything?
[AGENT][NEUTRAL] My name again is [PII]. My name and today's date would be your call reference number.
[AGENT][NEUTRAL] And is there anything else? [PII].
[CUSTOMER][NEUTRAL] Spell out your name?
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][POSITIVE] OK thank you and have a good day.
[AGENT][POSITIVE] You're very welcome. So again, if that's all I can help you with, thank you for calling APL and I hope you have a nice day as well.
[CUSTOMER][NEUTRAL] Yeah, bye bye.
[AGENT][NEUTRAL] Bye-bye.