AccountId: 011433970860
ContactId: 29cb20d1-d844-4b61-86a2-9eeff6ea9393
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236339 ms
Total Talk Time (AGENT): 96394 ms
Total Talk Time (CUSTOMER): 52062 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/29cb20d1-d844-4b61-86a2-9eeff6ea9393_20250226T16:15_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII], and I'm calling from Knox Community Hospital regarding a claim.
[AGENT][POSITIVE] All right, [PII]. Happy to check a claim for you today. What's the patient policy number?
[CUSTOMER][NEUTRAL] That is 02555848.
[AGENT][NEUTRAL] OK, let me pull that up here.
[AGENT][NEUTRAL] And if I could get patient name and date of birth?
[CUSTOMER][NEUTRAL] Sure, patient's first name is [PII], last name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you so much. And then what's the date of service?
[CUSTOMER][NEUTRAL] I have two claims for the same data service. It's for [PII]. The first one is for $4,752.85.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the second one is for $67.80.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] So the first claim for the $4,752.85 it looks like we did receive that. I show there was a benefit payment sent it looks like in the amount of $50.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, is it showing what the patient is?
[AGENT][NEUTRAL] No, it doesn't. It just shows, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like this is the max benefit for that date of service so as far as patient responsibility, yeah, that would just be up to the facility or provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now does it have a claim number on that?
[AGENT][NEUTRAL] Yes, ma'am, uh, claim number is going to be 356.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 753 1.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Let me check for the other one.
[AGENT][NEUTRAL] 6
[AGENT][NEGATIVE] OK. And then the second claim for the 6780, it looks like we did receive. Um, it looks like a medical test for the state of service is not a covered diagnostic test. Therefore, there was no benefit payable.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um claim number on that one please.
[AGENT][NEUTRAL] That is going to be 3555.
[AGENT][NEUTRAL] 855.
[CUSTOMER][NEUTRAL] Alright, and do you give reference numbers for your calls?
[AGENT][NEUTRAL] Absolutely, [PII], that's gonna be my name with my last initial in today's date. My name again is [PII], which is [PII] My last initial is [PII].
[CUSTOMER][POSITIVE] All right well thank you very much for your help I appreciate it.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][NEUTRAL] Bye bye