AccountId: 011433970860
ContactId: 2df34ed2-f34a-46a0-9e41-385406088a89
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 455339 ms
Total Talk Time (AGENT): 82024 ms
Total Talk Time (CUSTOMER): 125585 ms
Interruptions: 6
Overall Sentiment: AGENT=1.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/2df34ed2-f34a-46a0-9e41-385406088a89_20250404T13:28_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office for claim status.
[AGENT][NEUTRAL] Sure, I can assist you with claim status. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] And may I have a callback number just in case we get disconnected? Yes, [PII]. It's a direct line.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Thank you. And may I have the patient's policy number? It's uh 02334237.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] OK thank you.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Yeah, I do apologize, but OK, the system is not coming. Um, do you mind holding for me just a minute, Mr. [PII]?
[CUSTOMER][NEUTRAL] OK, I do apologize, but OK, the system is not coming. Um, do you mind holding for me just a moment. OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being for Mr. [PII].
[CUSTOMER][POSITIVE] Thank you for holding and being for Mrs. [PII]. Yes.
[AGENT][NEUTRAL] OK. Um, um, I got it up. Um, what is the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] OK. Um, um, I got it up. Um, what is the name and date of birth of the patient? Uh, [PII]. Date of birth on [PII].
[AGENT][NEUTRAL] Thank you. And what's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Thank you. And what's the date of service and the amount of the claim? [PII] and bill amount to $6,307.52.
[AGENT][NEUTRAL] OK, that's [PII], correct?
[CUSTOMER][NEUTRAL] Mhm. That was [PII], correct? Yes.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let me pull this EOB and for future, you can check status online through our website at [PII].
[CUSTOMER][NEUTRAL] Let me pull the EOB and for future you can check the status online through our website at [PII].
[AGENT][NEUTRAL] That's just optional.
[CUSTOMER][NEUTRAL] That's just optional.
[AGENT][NEUTRAL] It looks like we processed the claim on [PII] and the claim was denied. The reason for this denial is the outpatient benefits for the calendar year has been met.
[CUSTOMER][NEUTRAL] It looks like we processed the claim on [PII] and the claim was denied. The reason for this denial is the outpatient benefits for the calendar year have been met.
[CUSTOMER][NEUTRAL] Bets have been met.
[AGENT][NEUTRAL] Yes, has been exhausted. That's what it means.
[CUSTOMER][NEUTRAL] Yes, I've been exhausted. OK, my claim number.
[AGENT][NEUTRAL] OK, the claim number is 3570121.
[CUSTOMER][NEUTRAL] OK, the claim number is 3570121.
[CUSTOMER][NEUTRAL] 3570121.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes. OK uh call reference number?
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name and today's date if you will.
[CUSTOMER][NEUTRAL] We don't have reference numbers. You can use my name and today's date if you will. OK, thank you.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Mr. [PII]?
[CUSTOMER][POSITIVE] You're welcome. Is there anything else I can help you with today, Mrs. No, thank you. Thanks for your assistance.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] You're welcome. Thank you for calling ATL. Have a good day.