AccountId: 011433970860
ContactId: 01b7e1a7-9464-4490-be10-7d0d60b53579
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 414399 ms
Total Talk Time (AGENT): 79459 ms
Total Talk Time (CUSTOMER): 105958 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/01b7e1a7-9464-4490-be10-7d0d60b53579_20250418T15:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII]. I'm calling from Aiken Regional Medical Center for Claims, please.
[AGENT][NEUTRAL] OK, I can help you with claim status and what was your name?
[CUSTOMER][NEUTRAL] Uh yes, that is [PII].
[AGENT][NEUTRAL] OK, thank you and do you have a good callback number?
[CUSTOMER][NEUTRAL] Uh yes, that is [PII].
[AGENT][NEUTRAL] OK, do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Uh yes, the policy number is 02038519.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh yes, patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and you have the uh date of service?
[CUSTOMER][NEUTRAL] Uh yes, that is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the bill charges?
[CUSTOMER][NEUTRAL] That is $3,571.
[CUSTOMER][NEUTRAL] And this is actually a processed and paid claim, and we submitted the underpayment appeal for this claim, um, by mail which is delivered on [PII] [PII], and I'm looking for the status of that underpayment appeal if you received that.
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] I'm sorry, what was that date of service? [PII], is that right?
[CUSTOMER][NEUTRAL] Uh, the date of service was.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, let me see, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, I'm having trouble locating the appeal. Let me pull up a different.
[AGENT][NEUTRAL] So it wasn't covered, but let me see. Hold on one moment.
[CUSTOMER][POSITIVE] Uh, no problem.
[AGENT][NEUTRAL] OK, it looks like we did send a letter.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] On [PII].
[AGENT][NEUTRAL] And that the original processing stands.
[CUSTOMER][NEUTRAL] I related to a
[CUSTOMER][NEUTRAL] In
[AGENT][NEUTRAL] You need me to fax you that letter or?
[CUSTOMER][NEUTRAL] Yes please, because we haven't received it. If you mailed it already, um, I would be appreciated that if you can, uh, fax it to me.
[AGENT][NEUTRAL] OK, what's your fax number?
[CUSTOMER][NEUTRAL] And that is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 4756.
[AGENT][NEUTRAL] Could you spell your first name for me one more time?
[CUSTOMER][NEUTRAL] Uh yes, that is [PII].
[AGENT][NEUTRAL] OK. [PII]
[AGENT][NEUTRAL] Sorry, I'm not unders
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, [PII] Victor.
[AGENT][NEUTRAL] VIR.
[CUSTOMER][NEUTRAL] Yeah yeah.
[AGENT][NEUTRAL] R [PII] J V [PII] [PII], is that right?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, mhm, that's correct.
[AGENT][NEUTRAL] OK, I'll get that faxed over.
[CUSTOMER][NEUTRAL] And you're saying this deal is.
[AGENT][NEUTRAL] Yeah, so this, this is a, yes, it is, um, this is a hospital indemnity plan. So this is a very limited plan. It's not a major medical plan.
[CUSTOMER][NEUTRAL] upheld
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So it, it pays very specific amounts for very specific services.
[CUSTOMER][POSITIVE] Got it, thank you, thank you so much, [PII], and I'll, I will be receiving that fax today or like in a 2 or 3 days.
[AGENT][NEUTRAL] Uh, no, I'll send it right now. Just give me about 5 minutes.
[CUSTOMER][POSITIVE] Thank you, thank you so much.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] You too take care.