AccountId: 011433970860
ContactId: 360c4a07-263f-4abc-8ccb-51a723d3e122
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166240 ms
Total Talk Time (AGENT): 72610 ms
Total Talk Time (CUSTOMER): 46697 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/360c4a07-263f-4abc-8ccb-51a723d3e122_20250213T15:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, Ms. [PII]. My name is [PII], and I am calling from McCloud Lower Seacoast Hospital, and I was calling to get claim status for a patient, please.
[AGENT][POSITIVE] All right, I'm happy to check on the claim this morning. Do you have the policy number?
[CUSTOMER][NEUTRAL] I do, um, the member's ID is 02506204.
[AGENT][POSITIVE] Great, thank you so much. Let me take a look here one moment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if I could get the patient name and date of birth?
[CUSTOMER][NEUTRAL] This is for [PII], [PII].
[AGENT][NEUTRAL] Alright, thank you. And then date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] In the bill amount.
[CUSTOMER][NEUTRAL] $11,319.00.
[AGENT][NEUTRAL] Alright, let me take a look and see what we got here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] It looks like we did receive a claim for this on [PII]. We need the explanation of benefits from the primary to process this, so it's been denied at this point.
[CUSTOMER][NEUTRAL] OK, so Ms. [PII], does it say who is the primary because that's the only insurance that we have listed.
[AGENT][NEUTRAL] Oh, no, it doesn't. We unfortunately don't have that info. That would be something you'd have to check with the insured on.
[CUSTOMER][NEUTRAL] OK, so but y'all are showing that she has another insurance.
[AGENT][NEUTRAL] Well, this plan that she has with us is a secondary insurance, so it's like a gap plan. So it'll only pick up what the primary does not. So she should have something else out there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll give her a call and mister, can I get the first digit of your last name from my notes?
[AGENT][POSITIVE] Yeah, absolutely. That's [PII].
[CUSTOMER][NEUTRAL] OK, and is there a reference number for this call today?
[AGENT][NEUTRAL] Yes, absolutely. That is my name with my last initial and then today's date, that would be the call reference.
[CUSTOMER][POSITIVE] OK, uh thank you so much and you have a wonderful day.
[AGENT][POSITIVE] You too take care bye bye.
[CUSTOMER][NEUTRAL] Bye bye.