AccountId: 011433970860
ContactId: 123d2df6-5708-48d7-998e-ff03c902b140
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 311899 ms
Total Talk Time (AGENT): 77696 ms
Total Talk Time (CUSTOMER): 104417 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/123d2df6-5708-48d7-998e-ff03c902b140_20250328T20:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office. Just want to verify the um claim status.
[AGENT][NEUTRAL] OK, and I can help you with claim status. What's a good callback number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Callback number is um.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] It was, I'm sorry, it was [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] You have the patient policy ID?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, that is.
[CUSTOMER][NEUTRAL] 02377560.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] And what was that date of service?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] That is [PII] and the bill amount is $35,0293.63.
[CUSTOMER][NEUTRAL] And can you just spell out your name?
[AGENT][NEUTRAL] Yes, it's [PII]. It's [PII] Last initial is [PII].
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And on this claim it looks like um.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I think.
[AGENT][NEUTRAL] Uh, the policy does not cover diagnostic testing.
[CUSTOMER][NEUTRAL] What?
[AGENT][NEUTRAL] And then outpatient services are not covered under this policy.
[CUSTOMER][NEUTRAL] OK, just a minute.
[CUSTOMER][NEUTRAL] You did
[CUSTOMER][NEUTRAL] You said that um claim is denied, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, can you, uh, can you just provide me the claim received date?
[AGENT][NEUTRAL] Uh, received date is.
[AGENT][NEUTRAL] Now receive date was [PII].
[CUSTOMER][NEGATIVE] Denied.
[AGENT][NEUTRAL] Denied [PII].
[CUSTOMER][NEUTRAL] Sting us. Can you just repeat that once again slowly so that I can just make a note of it?
[AGENT][NEGATIVE] Uh, it's got two denial reasons. The policy does not provide.
[AGENT][NEUTRAL] Any benefits for diagnostic testing?
[CUSTOMER][NEGATIVE] Does not provide uh any benefits for diagnostic.
[AGENT][NEUTRAL] Testing.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Testing was the last word.
[CUSTOMER][NEUTRAL] Testing.
[AGENT][NEUTRAL] Testing, yes.
[AGENT][NEUTRAL] And then outpatient services.
[AGENT][NEGATIVE] are not covered under this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Outpatient.
[CUSTOMER][NEGATIVE] Services are not covered.
[CUSTOMER][NEUTRAL] OK, can you just send me the copy of EOB?
[AGENT][NEUTRAL] OK, what's your fax number?
[CUSTOMER][NEUTRAL] That is
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Hey, can I help with anything else today, [PII]?
[CUSTOMER][NEUTRAL] Uh, can you just provide me the call reference number?
[AGENT][NEUTRAL] Uh it's my first name. Last initial is [PII].
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][POSITIVE] OK. Thank you. Have a nice day. Bye-bye.
[AGENT][POSITIVE] Alright, thank you for calling ATL. Thank you.