AccountId: 011433970860
ContactId: fdf2f37c-5afd-4d24-8fa4-02b413f6ddbc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 199250 ms
Total Talk Time (AGENT): 56539 ms
Total Talk Time (CUSTOMER): 61549 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/fdf2f37c-5afd-4d24-8fa4-02b413f6ddbc_20250327T19:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Memorial Healthcare, and I'm calling about the status of a claim of mine.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Sure, I can check on a claim for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] What was your name again? Sorry.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] That's OK, [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And did you have that policy number?
[CUSTOMER][NEUTRAL] I do. It is 02230090.
[AGENT][NEUTRAL] OK, and uh what was the name and date of birth for the number, please?
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And then uh do you have that bill amount?
[CUSTOMER][NEUTRAL] Yes, the total bill amount was $220 primary insurance, um, process leaving your co-pay of $70.
[AGENT][NEUTRAL] 70. OK, thank you. One moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, bear with me just a moment. I do believe I found it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, so I did, we did receive this claim, we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK, so I'm guessing the 1024 24 data service is probably the same thing?
[AGENT][NEUTRAL] I can check that. Let's see, was that the same bill amount?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, let me just double check.
[CUSTOMER][NEUTRAL] No, that one was.
[CUSTOMER][NEUTRAL] 392.75 billing you guys a total of $35 looks like yeah.
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEGATIVE] Yeah, um, that's the same one as well. uh, office visits are not covered, so we were unable to pay that benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you so much [PII] I will build the patient.
[AGENT][NEUTRAL] Of course. Was there anything else I can help you with?
[CUSTOMER][POSITIVE] Nope, that's it thank you.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][POSITIVE] Thank you, bye bye.