AccountId: 011433970860
ContactId: f9135308-bd1d-4be5-9e07-0b10d52111b3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 263579 ms
Total Talk Time (AGENT): 86272 ms
Total Talk Time (CUSTOMER): 79886 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/f9135308-bd1d-4be5-9e07-0b10d52111b3_20250103T19:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling for the provider to check on additional information on a claim that has been denied. Please note, this call will be monitored and recorded for quality and training purposes.
[AGENT][POSITIVE] All right. I'm happy to check on the claim for you today, [PII]. What is the policy number?
[CUSTOMER][NEUTRAL] That would be 023.
[CUSTOMER][NEUTRAL] 563
[CUSTOMER][NEUTRAL] I'm sorry, it's 56,530.
[AGENT][POSITIVE] Thank you and do you have a good call back number?
[CUSTOMER][NEUTRAL] That would be [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It's a direct line.
[AGENT][NEUTRAL] Thank you for that. And what's the patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is?
[CUSTOMER][NEUTRAL] [PII], with the date of birth [PII].
[AGENT][NEUTRAL] Thank you. And then what's the date of service?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] For the total charges of $966 even.
[AGENT][NEUTRAL] All right. Do you have, let's see, you said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I don't show any claims on file for $966. Do you have the claim number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Is there one for $888?
[AGENT][NEUTRAL] Yeah, we do have a claim for $888 yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And the claim number is 353-6166.
[AGENT][NEUTRAL] The original claim number is 3402218.
[CUSTOMER][POSITIVE] Thank you. And I'm calling on that claim.
[AGENT][NEUTRAL] OK, so it looks like.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Claim was received [PII].
[AGENT][NEUTRAL] Uh, the claim was denied. It looks like the member was not eligible at the time of service. Let me double check the effective dates.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So the plan effective date was [PII]. The policy terminated [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEGATIVE] The member was not active at the time of service.
[CUSTOMER][NEUTRAL] And was there any other plan that was active for this data service?
[AGENT][NEGATIVE] Not with us, there was not.
[CUSTOMER][NEUTRAL] Thank you. And a card reference number, please?
[AGENT][NEUTRAL] Call references my name with my last initials and today's date. My name again is [PII], that's spelled [PII] Last initial is [PII].
[CUSTOMER][POSITIVE] Thank you for your assistance, [PII]. Have a great day.
[AGENT][POSITIVE] You're welcome. You too, [PII].
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Yeah