AccountId: 011433970860
ContactId: 2f66c410-640c-4746-8971-0f6d08e4efd6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226100 ms
Total Talk Time (AGENT): 76684 ms
Total Talk Time (CUSTOMER): 50995 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/2f66c410-640c-4746-8971-0f6d08e4efd6_20250407T18:56_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I am calling from Knox Community Hospital. I am needing to check the status of a claim, please.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] 024014007.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what was the date of service?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And do you have the bill charges?
[CUSTOMER][NEUTRAL] Uh, $1,711.05.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] OK, it looks like we received that let's see.
[AGENT][NEUTRAL] Um, that was received on
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] 99 2024, uh process 9-16 2024.
[AGENT][NEGATIVE] And it looks like it was denied, and that was for.
[AGENT][NEUTRAL] Uh, the medical test for the data service is not a covered diagnostic test under the policy. Um, the covered tests include MRI, CAT scan, uh, thyroid uptake test.
[AGENT][NEUTRAL] Uh, PET scan, angiogram.
[AGENT][NEUTRAL] Mariogram.
[AGENT][NEUTRAL] Um, lower GI series, upper GI series.
[AGENT][NEUTRAL] Nuclear stress tests, sleep study, and transesophageal echocardiogram.
[CUSTOMER][NEUTRAL] So they only covers rad tests.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. Is there um the claim number?
[AGENT][NEUTRAL] Uh, claim number is 3505314.
[CUSTOMER][NEUTRAL] Is there any way you can fax me a copy of that remit?
[AGENT][NEUTRAL] Sure, what's your fax?
[CUSTOMER][NEUTRAL] Sure. It is [PII].
[AGENT][NEUTRAL] OK, I'll get that faxed over right now. Just give me a few moments.
[CUSTOMER][NEUTRAL] OK, and is there a reference number for our call, [PII]?
[AGENT][NEUTRAL] A reference number will just be my name, [PII], first initial of my last name which is [PII], and then today's date.
[CUSTOMER][POSITIVE] Alrighty I appreciate your help today.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Thanks you as well bye bye.
[AGENT][NEUTRAL] Bye