AccountId: 011433970860
ContactId: 13f13e02-57f2-4c7e-94f3-43c3a6acfaff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210970 ms
Total Talk Time (AGENT): 69089 ms
Total Talk Time (CUSTOMER): 51103 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/13f13e02-57f2-4c7e-94f3-43c3a6acfaff_20250207T16:46_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I was calling to check claim status.
[AGENT][NEUTRAL] OK, I can help you. What's your name?
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[AGENT][NEUTRAL] [PII], OK. And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Uh, that is.
[CUSTOMER][NEUTRAL] 253-916-6
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], uh, date of birth is uh [PII].
[AGENT][NEUTRAL] OK, thank you for that information, [PII], and we're checking claim status.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, we can help you with that information. What's the date of service in charge?
[CUSTOMER][NEUTRAL] Uh, data service is [PII]. Uh, total charge is.
[CUSTOMER][NEUTRAL] Um, $527.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I show the claim was processed [PII]. Saint Ann's Hospital.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] And there was no payment made on the claim for the explanation of benefit it cites that the medical test for this state of service is not a covered diagnostic test, therefore benefits are not payable.
[AGENT][NEUTRAL] So what type of test was it?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh sorry, it's taking a second for my computer to move.
[AGENT][NEUTRAL] No, that's OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I can't tell. All I'm seeing is radiology is all I'm seeing.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, and so it's not a covered test under this policy, so there was not a payment um made and did you need the claim number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yes, I'll take the claim number.
[AGENT][NEUTRAL] Um, that's 354.
[AGENT][NEUTRAL] 546 5.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Is there a call reference number?
[AGENT][NEUTRAL] You'll use my name in today's status reference for today's call. It's [PII] First initial of my last name is [PII]. And any other questions?
[CUSTOMER][POSITIVE] Uh, that's all I had today, thank you.
[AGENT][POSITIVE] You're welcome thanks for calling APL have a good day.
[CUSTOMER][NEUTRAL] You too. Goodbye.