AccountId: 011433970860
ContactId: fd7f5e3c-94c2-414c-816e-2fd72d198f3a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 207839 ms
Total Talk Time (AGENT): 75314 ms
Total Talk Time (CUSTOMER): 66575 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/fd7f5e3c-94c2-414c-816e-2fd72d198f3a_20250414T13:25_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] Hi, [PII]. My name is [PII] calling from provider's office, checking on a claim status for today.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with your claim status. And [PII], how many claims do you have in total today?
[CUSTOMER][NEUTRAL] One claim?
[AGENT][NEUTRAL] Alright and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yup, sure. That is uh.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It is 02584435.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure. That is [PII] and the date of birth is going to be [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 bill?
[CUSTOMER][NEUTRAL] Yeah, sure. Before that, could you please spell out your name for me?
[AGENT][NEUTRAL] Yes, my name is [PII].
[CUSTOMER][POSITIVE] All right, [PII], thank you so much for that. And the date of service is [PII] for $632 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Sure, that is not in Hospital?
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Alright, I'm sure you received the claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 3571829.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[AGENT][NEUTRAL] Because the medical test for this data service is not a covered diagnostic test.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Alright, so it is not covered under the patient's plan or the provider's contract.
[AGENT][NEUTRAL] Um, patients plan.
[CUSTOMER][NEUTRAL] Oh, alright, the full, uh, the full balance is going to be covered under the patient, patient span. Am I right?
[AGENT][NEUTRAL] is not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Alright, uh, can I get the, uh, reference number for this call, [PII]?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date.
[CUSTOMER][POSITIVE] All right, sure, and uh thank you so much for the call. Have a great day and stay safe. Take care. Bye-bye.
[AGENT][NEUTRAL] You're welcome, [PII]. Was there anything else I can help with?
[CUSTOMER][POSITIVE] Um, no, that's it for today. Thank you so much.
[AGENT][POSITIVE] Alright, thanks for calling APL. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye bye.