AccountId: 011433970860
ContactId: 044a00e2-7933-47ff-a1de-1acd1422b7e4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 447809 ms
Total Talk Time (AGENT): 109761 ms
Total Talk Time (CUSTOMER): 64187 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/044a00e2-7933-47ff-a1de-1acd1422b7e4_20250611T19:02_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] Uh yes, my name is [PII]. I am with North Mississippi Hill Services and I'm just calling to find out the status of a of a claim, please.
[AGENT][POSITIVE] OK, sure, I can assist you with claims, Miss [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Direct line is [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It is 02594090.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] Thank you and what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Uh, data service [PII]. The bill amount is $31.
[AGENT][NEUTRAL] OK. OK, let me see if I can find this claim for you, and that was [PII], correct?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, let me pull this 11 moment.
[AGENT][NEUTRAL] Alright, OK, I'm waiting for the EOB and for future you can check claim status online through our website at [PII] and that's just optional.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] I'm still waiting on the ELB one moment.
[AGENT][NEUTRAL] OK. So it looks like we processed the claim on [PII] and the claim was denied. The denial reason is that outpatient service less than 18 hours is not covered under the member's plan.
[CUSTOMER][NEUTRAL] Outpatient what now?
[AGENT][NEUTRAL] Outpatient service or outpatient facility, less than 18 hours is not covered under the member's plan.
[CUSTOMER][NEUTRAL] Outpatient
[CUSTOMER][NEGATIVE] In 18 hours not covered.
[CUSTOMER][NEUTRAL] Alrighty, uh, is there any way I can get a copy of that?
[AGENT][NEUTRAL] Uh, yes, what is the fax number?
[CUSTOMER][NEUTRAL] [PII] attention order.
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct. Correct.
[AGENT][NEUTRAL] How do you spell your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh, I have it. OK, um, do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Ms. [PII]. OK, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Uh, no, ma'am, I just need a, uh, do you, do you have a call reference number?
[AGENT][NEUTRAL] We don't. You can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK and your name again?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] Thank you so appreciate it.
[AGENT][POSITIVE] You're welcome. All right. Have a good afternoon. You too. Thank you. Bye-bye.
[CUSTOMER][POSITIVE] You have a good afternoon. Thank you uh huh bye bye.