AccountId: 011433970860
ContactId: 278f8ae9-8ef0-4901-b1bc-ba84cb86bfc2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326619 ms
Total Talk Time (AGENT): 85786 ms
Total Talk Time (CUSTOMER): 59709 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/278f8ae9-8ef0-4901-b1bc-ba84cb86bfc2_20250325T12:27_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, I'm calling for a claim status.
[AGENT][NEUTRAL] Your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And are you calling on behalf of a provider's office?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And what's the policy number, [PII], and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] The policy number is 259-0539. callback number is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And if you can verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thanks for that information, uh, [PII], and we're checking claim status for what date?
[CUSTOMER][NEUTRAL] It is for [PII].
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] 9, I'm sorry, $9,496.01.
[AGENT][NEUTRAL] OK, is this a facility charge or professional fee?
[CUSTOMER][NEUTRAL] Facility.
[AGENT][NEUTRAL] OK. Give me 1 2nd.
[AGENT][NEUTRAL] It's an emergency room visit?
[CUSTOMER][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] Um, it might be. I'm not 100% sure. It doesn't, I can't really see that stuff.
[AGENT][NEUTRAL] Can you give me the name of the hospital?
[CUSTOMER][NEUTRAL] Bluegrass Community Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm still looking
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So, was this related to an accident, it was denied because this policy covers as a result of an accident.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And not sickness.
[AGENT][NEUTRAL] And let me know when you're ready for that claim number.
[CUSTOMER][NEUTRAL] May I have the claim number?
[AGENT][NEUTRAL] The claim number is 357-041-7 and you can also check claim status online at [PII] and did you have any other questions, [PII], I can help out with today?
[CUSTOMER][NEUTRAL] Um, do you know when it was received?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So the claim was received [PII], processed [PII].
[AGENT][NEUTRAL] 25.
[CUSTOMER][NEUTRAL] And you said it only covers accidents?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And by any chance are you able to fax me a copy of the EOB?
[AGENT][POSITIVE] It was actually mailed uh the next business day when it processed so it's available for you to download online using the claim number provided. I can help you set that account up if you would like.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] It's alright, thank you. I appreciate it. And then may I have a reference number?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII], first initial last name is [PII], and any other questions, [PII] I can help out with today?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] Alrighty thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You as well. Bye-bye.