AccountId: 011433970860
ContactId: 01cd13f7-c009-43d9-a282-52beac212186
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 323029 ms
Total Talk Time (AGENT): 85565 ms
Total Talk Time (CUSTOMER): 111547 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/01cd13f7-c009-43d9-a282-52beac212186_20250327T18:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. Can I help you?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII], and I'm calling for providers to check on the additional information about a claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes. How are you doing today?
[AGENT][POSITIVE] I'm good, [PII]. Thank you for asking. I'm happy to check on a claim. What is the patient policy number?
[CUSTOMER][NEUTRAL] Yes, the patient's policy number will be, which is D as in David 42026895.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] Thank you. Unfortunately, I can't pull the number with that number. Do you have their name or social?
[CUSTOMER][NEUTRAL] Yeah, I have a social. One moment, please. Let me pull that up. The Social Security number will be
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] One moment please. Let me do a search for that.
[AGENT][NEUTRAL] And [PII], do you have a good call back number in case we're disconnected?
[CUSTOMER][NEUTRAL] Really?
[CUSTOMER][NEUTRAL] Sure, it will be [PII]. This is the direct line with no extension. May I get your name, please? Your name is [PII]?
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm. And that is [PII]
[CUSTOMER][NEUTRAL] Initial last name will be?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII]. Thank you.
[AGENT][NEUTRAL] You're welcome. And then what's the patient's name?
[CUSTOMER][NEUTRAL] Yes, the name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. And then what is the data service?
[CUSTOMER][NEUTRAL] 211 of 2025 for $402.21.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] That you
[CUSTOMER][NEUTRAL] I don't know
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] With you
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] And the bill amount was $211.25.
[CUSTOMER][NEUTRAL] 211, no, no, it's $402.21.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] I don't know that's that's.
[CUSTOMER][NEUTRAL] what
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So we did receive a claim for the state of service claim was received on [PII].
[AGENT][NEGATIVE] The claim was denied. Uh, looks like a policy did not provide any benefits for the services rendered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, 993-8596127 it's not a covered service and that the patient's plan, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] This was denied on [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] The patient's plan name will be?
[AGENT][NEUTRAL] Uh, the patient has a limited benefit hospital indemnity plan.
[CUSTOMER][NEUTRAL] Limited benefit
[CUSTOMER][NEUTRAL] Limited benefit hospital.
[CUSTOMER][NEUTRAL] Indemnity.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] plan
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] Call reference number.
[AGENT][NEUTRAL] [PII] references my name with my last initial than today's date. My name again is [PII], last initial is [PII], and today's date.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much for providing the valuable information and wonderful assistance.
[AGENT][POSITIVE] You're welcome. Is there anything else I can do for you?
[CUSTOMER][NEUTRAL] No, no, that's all.
[AGENT][POSITIVE] All right, thanks so much.
[CUSTOMER][NEUTRAL] The claim number is, uh yeah, claim number is ending with, which is 9645, right?
[AGENT][NEUTRAL] That is correct, [PII], uh-huh.
[CUSTOMER][POSITIVE] Thank you. Have a good one. Bye now.
[AGENT][NEUTRAL] You too. Bye bye.