AccountId: 011433970860
ContactId: 156ed7c8-cc5a-4420-b1f4-d45fe67e1e87
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 368859 ms
Total Talk Time (AGENT): 90078 ms
Total Talk Time (CUSTOMER): 74330 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/156ed7c8-cc5a-4420-b1f4-d45fe67e1e87_20250114T18:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from Lake Cumberland Regional Hospital to check the status of a claim.
[AGENT][NEUTRAL] OK, I can help you with claim status. Can you please spell your first name for me?
[CUSTOMER][NEUTRAL] Sure, the first name of.
[CUSTOMER][NEUTRAL] Uh [PII]
[AGENT][NEUTRAL] OK, she probably, what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much. And then what is the patient's name?
[CUSTOMER][NEUTRAL] Patient name is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] OK your date of birth is [PII].
[AGENT][NEUTRAL] And the policy numbers?
[CUSTOMER][NEUTRAL] Policy number is
[CUSTOMER][NEUTRAL] 02520305
[AGENT][NEUTRAL] OK, let me pull in that policy for us real quick.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and what is the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] $4,238.81.
[AGENT][NEUTRAL] OK, and you said you were calling from Cumberland Hospital?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, Ms. [PII], while I pull up this claim for you and I'll be right back.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Hi [PII], this is [PII] back with you again.
[AGENT][NEUTRAL] And I do have the claim for you.
[AGENT][NEUTRAL] The claim number is 352.
[AGENT][NEUTRAL] 6088.
[AGENT][NEUTRAL] And the claim was denied.
[AGENT][NEUTRAL] Because the insured was not eligible for the date of service.
[CUSTOMER][NEUTRAL] May I know the received date?
[AGENT][NEUTRAL] Yes, ma'am. Let me give that to you.
[AGENT][NEUTRAL] Received on
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And processed on [PII].
[CUSTOMER][NEUTRAL] So, as you said, this claim is denied as the member is not active on date of service. So may I know the effective date?
[AGENT][NEUTRAL] Yes, the effective date of the policy is [PII].
[AGENT][NEUTRAL] And the policy terminated on [PII].
[CUSTOMER][POSITIVE] OK, thank you for providing me the necessary information.
[CUSTOMER][NEUTRAL] May I have, just give me a moment.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Yes, so may I have call reference number for our call?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] You can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] OK. Thank you for providing me the necessary information. Have a nice day. Stay safe. Bye-bye for now.
[AGENT][POSITIVE] You too, [PII]. You have a blessed day. Thanks for calling APL. Bye bye.
[CUSTOMER][NEUTRAL] You too. Bye-bye.