AccountId: 011433970860
ContactId: f74fc75a-0ac5-4b15-9a8c-0f869509e124
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 185669 ms
Total Talk Time (AGENT): 82221 ms
Total Talk Time (CUSTOMER): 41926 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/f74fc75a-0ac5-4b15-9a8c-0f869509e124_20250416T16:20_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi [PII], my name is [PII] and I'm calling on behalf of a medical provider and I'm calling trying to um get claim status for a patient.
[AGENT][NEUTRAL] OK, well, I can help you with the claim status, [PII]. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 02179701
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[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 and the total bills?
[CUSTOMER][NEUTRAL] [PII] for $127.
[AGENT][NEUTRAL] All right, hold on one moment.
[AGENT][NEUTRAL] 427 here we go.
[AGENT][NEUTRAL] Alright, so I'm showing the claim was received on [PII], I'm sorry, [PII].
[AGENT][NEUTRAL] And that claim number is 353-4374.
[AGENT][NEUTRAL] And on [PII], the claim was processed. Um, it's pending. Well, let me double check that. Hold on one second.
[AGENT][NEGATIVE] The denial reasons coming up now.
[AGENT][NEUTRAL] OK, so no premium was received for that data service, um, therefore, no benefits can be paid.
[CUSTOMER][NEGATIVE] No premium receive for data service.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And what was the rest of the denial?
[AGENT][NEUTRAL] Um, service, um, therefore, no benefits are payable.
[CUSTOMER][NEUTRAL] Alright, is there a reference number for today's 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] Alrighty, thanks for all your help. You have a great day today.
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I can help with?
[CUSTOMER][POSITIVE] No, that'll be all thank you.
[AGENT][POSITIVE] All right, thanks for calling APL. You're welcome. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye.