AccountId: 011433970860
ContactId: 22bd3e8b-9ffb-4d45-9cc4-4c44d66b2fec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 153279 ms
Total Talk Time (AGENT): 43432 ms
Total Talk Time (CUSTOMER): 39132 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/22bd3e8b-9ffb-4d45-9cc4-4c44d66b2fec_20250402T14:53_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII]. This is [PII]. I'm calling um from Ensemble Health Group. How are you?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] Good, I wanted to check the status of a claim for a patient please.
[AGENT][POSITIVE] I'll be happy to assist with claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] Policy number is 02168442.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] And what's the date of service for that claim?
[CUSTOMER][NEUTRAL] [PII] and the billed amount of $45.
[AGENT][POSITIVE] Thank you for that information.
[AGENT][NEUTRAL] OK, I'm showing the claim was denied because it was not covered by the insurance, the major medical.
[CUSTOMER][NEUTRAL] OK, so that covered?
[AGENT][NEUTRAL] By the major medical, there was, um, it shows that they didn't.
[AGENT][NEUTRAL] Let me pull up the um EOB so I can get the exact.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I'm showing that.
[AGENT][NEGATIVE] It wasn't covered. It was a non-covered charge.
[AGENT][NEUTRAL] So there was nothing applied to deductible, co-pay, or co-insurance, so there was nothing for us to pay.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, just wanted to double check on that and do you have a call reference number? I just use your name and today's date?
[AGENT][NEUTRAL] It's my name and today's date and time. Was there anything else I can assist with today?
[CUSTOMER][POSITIVE] That's all. Thank you for your help.
[AGENT][POSITIVE] Thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too.