AccountId: 011433970860
ContactId: f6bc4ea5-b048-4211-a74e-0fb960d40daa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230529 ms
Total Talk Time (AGENT): 98131 ms
Total Talk Time (CUSTOMER): 61723 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/f6bc4ea5-b048-4211-a74e-0fb960d40daa_20250121T15:44_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good good morning. Thank you for calling APM. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from provider's office and I'm looking for claim status.
[AGENT][POSITIVE] OK, I'll be more than happy to assist you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] I have only one member.
[AGENT][NEUTRAL] OK. May I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yeah, contact number is [PII].
[CUSTOMER][NEUTRAL] With extension [PII].
[AGENT][POSITIVE] Thank you for that, and the policy number?
[CUSTOMER][NEUTRAL] 01835781.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, sure my name is [PII] and date of birth is [PII].
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you'd like me to check on?
[CUSTOMER][NEUTRAL] Yeah, that was it is [PII].
[CUSTOMER][NEUTRAL] And bill amount is $6200 even.
[AGENT][NEUTRAL] Thank you. And just for the call again, all the information provided is a verification of benefits, not a guarantee of payment. And hold on one moment while I locate the claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's $6200?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold while I locate the claim for you?
[CUSTOMER][NEUTRAL] Sure. I also have a claim number if you need.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, what's the claim number?
[CUSTOMER][NEUTRAL] It is 3,531,040.
[AGENT][NEUTRAL] OK, it's the first one. Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so what questions did you have in reference to the claim?
[CUSTOMER][NEUTRAL] I'm just looking for general status.
[AGENT][NEUTRAL] So the claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the claim was processed on [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the claim was denied because the policy does not provide a wellness benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you please the fact that denial of your your number fax.
[AGENT][NEUTRAL] Sure, what's a good fax number for you?
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do I need to put attention, [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, well, I'll go ahead and send this over to you now. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Mm, how much time it will take to see?
[AGENT][NEUTRAL] Um, we can't really tell you when a fax will be received, but we usually say to give it about an hour at least to to receive it.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] Alright, but if you have not received it by the end of day today, you can definitely give us a call and we'll be more than happy to resend it for you.
[CUSTOMER][POSITIVE] OK, thank you. I'm done.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] All right, was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] No, I'm done. Thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.