AccountId: 011433970860
ContactId: 33313e1a-e69d-459a-b2ec-23f5508734e3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211960 ms
Total Talk Time (AGENT): 92208 ms
Total Talk Time (CUSTOMER): 89770 ms
Interruptions: 2
Overall Sentiment: AGENT=1.6, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/33313e1a-e69d-459a-b2ec-23f5508734e3_20250506T15:51_UTC.wav
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[AGENT][NEUTRAL] APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII] from Mercy Clinic. I have a client with me which got denied, so I would like to uh have some additional information regarding the denial.
[AGENT][POSITIVE] All right, [PII], I'll be glad to help you. Go ahead and give me a good policy number, please, ma'am.
[CUSTOMER][NEUTRAL] Mhm. Yes, sure. The member ID is 01792084.
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number please, ma'am.
[CUSTOMER][NEUTRAL] Cleppe, and the callback number is [PII].
[AGENT][NEUTRAL] Alright, thank you so much sir, for all that information. Now your patient's name and date of birth today please ma'am.
[CUSTOMER][NEUTRAL] Mhm. Sure. The patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] What looks like [PII] is the insured on this medical supplemental plan, and you did say you want to check status of a claim that's been denied what date of service error.
[CUSTOMER][NEUTRAL] Yes, the date of service is uh [PII].
[AGENT][NEUTRAL] And how much is your total bill for 9:13?
[CUSTOMER][NEUTRAL] It is for $2,296 even.
[AGENT][POSITIVE] Alrighty, [PII], thank you for all that information. Let me see.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] You're welcome, love. And may I have your name spelled for the documentation purpose?
[AGENT][NEUTRAL] Yes, ma'am. [PII], my name is spelled [PII]
[CUSTOMER][NEUTRAL] Mm mhm.
[AGENT][NEUTRAL] All right, [PII], I do see that, oh yes, ma'am. OK, I do see the claim was denied. This patient has maxed out the benefit here at APL for their supplemental plan.
[CUSTOMER][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, may I know what was the uh maximum allowable for this plan?
[AGENT][NEUTRAL] Let's see, that max was $5000 and patient had already met it.
[CUSTOMER][NEUTRAL] And may I have the last met date?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Looks like [PII].
[CUSTOMER][NEUTRAL] I'm sorry. Can you repeat that again? July?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK. [PII]. Great. Thank you, thank you so much, love for the assistance. And yeah, for today's call, I have got enough information from you and thank you so much for that. Can I have the call reference number?
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] That's nice.
[AGENT][NEUTRAL] Well, is that all that I can help answer for you today, [PII]?
[CUSTOMER][POSITIVE] Yes, [PII]. Thank you for that and actually.
[AGENT][NEUTRAL] Alright, sir. Oh, yes, ma'am. And we do not give reference numbers, [PII], but you can use my name in today's date if you need to do so, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, thank you so much. I have got enough information from you for today's call. Have a great day.
[AGENT][POSITIVE] You as well, [PII], and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.