AccountId: 011433970860
ContactId: ff7cccd7-d64a-4850-9ef2-ae40b7c9857a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 212589 ms
Total Talk Time (AGENT): 86541 ms
Total Talk Time (CUSTOMER): 79653 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/ff7cccd7-d64a-4850-9ef2-ae40b7c9857a_20250403T14:54_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] Um, yes, [PII], I'm calling to get claim status, please.
[AGENT][NEUTRAL] OK, I can help you with the claim status. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. Last initial is um [PII] name. I can't talk this morning, last name initial is [PII], and my contact number that you can reach me at is [PII].
[AGENT][NEUTRAL] It's OK
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number that I'm showing for the number is 024950008.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Um, yes, the member's name is [PII]. Date of birth is [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] Yes, the date of service is [PII], and the bill amount is for $35,05.72.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Here it is.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][POSITIVE] Yes, it is Good [PII].
[AGENT][NEUTRAL] Um, OK, could it come up something else maybe? What's your tax ID?
[CUSTOMER][NEUTRAL] OK, tax ID number is [PII].
[AGENT][NEUTRAL] OK, it came up Harrison County Hospital, so I didn't know if that was the same thing or not.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Oh, OK. I don't.
[AGENT][NEUTRAL] But it's the same, but it's, it's the same tax ID and the same total bill, that just threw me off. So thank you for verifying and I am showing that the claim was received.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 357.
[AGENT][NEUTRAL] 1074.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], the claim was denied because the benefit maximum for the data service has been met.
[CUSTOMER][NEUTRAL] OK, so it's not patient responsibility or anything of that nature, right?
[AGENT][NEUTRAL] Well, we don't determine patient responsibility because we're not a major medical insurance company.
[CUSTOMER][NEUTRAL] But you said the benefit max has been met, that's what you say that?
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, can I get a call reference number if you don't mind?
[AGENT][NEUTRAL] Sure, 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] OK, thank you so much. You have a great rest of your day.
[AGENT][POSITIVE] Thank you, Ms. [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that's gonna be it.
[AGENT][POSITIVE] Alright, well, thanks for calling APL. I hope you have a great day as well.
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye bye.