AccountId: 011433970860
ContactId: fe18750b-478e-477b-862b-b2c1a73d67af
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242289 ms
Total Talk Time (AGENT): 99244 ms
Total Talk Time (CUSTOMER): 78054 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/fe18750b-478e-477b-862b-b2c1a73d67af_20250110T20:12_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling on behalf of the office checking for claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with the claim status, and I'm sorry, I didn't quite catch your name. Can you repeat your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. And may I
[CUSTOMER][NEUTRAL] Uh, my last name first initial is [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you. And may I have a callback number just in case we get disconnected, Ms. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] it's a direct line.
[AGENT][NEUTRAL] Mm thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Um, just a moment.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It's 021.
[CUSTOMER][NEUTRAL] 66
[CUSTOMER][NEUTRAL] 574.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh, name of the patient is [PII], and date of birth is [PII].
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Um, data services for [PII] with total charges of 19, I'm sorry, it's $1,952 1952 dollars even.
[AGENT][NEUTRAL] Alright, thank you. And let me see if I can find this claim for you and for future, you can check claim status online through our website at [PII] and that's just optional and bear with me.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so it looks like we processed this claim several times. I'm gonna give you the most recent process and bear with me just a second, let me pull the details.
[AGENT][NEGATIVE] OK, it looks like we received this claim on [PII], processed [PII], the same day, and it was processed and denied, stating that the service was rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] All right. Uh, and when it was terminated?
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] Alright, let me get that information for you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] It was terminated [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, and may I have the the date too?
[AGENT][NEUTRAL] The effective date was [PII].
[CUSTOMER][NEUTRAL] Alright, thank you so much. And as for the records, do you find any directive coverage of patients?
[AGENT][NEUTRAL] No, I'm with us.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] All right, thank you so much for that. Um, may I please call reference number?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] Yes, can you spell that for me?
[AGENT][NEUTRAL] Sure, that's [PII]. Last initial is [PII].
[CUSTOMER][POSITIVE] All right, thank you so much for your assistance and have a good day. Bye for now.
[AGENT][POSITIVE] Awesome, you as well, Miss [PII] and thank you for calling APL.