AccountId: 011433970860
ContactId: 3a07f49c-e10e-4b8b-acda-e74f75ce2a6c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 500179 ms
Total Talk Time (AGENT): 158362 ms
Total Talk Time (CUSTOMER): 99631 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/3a07f49c-e10e-4b8b-acda-e74f75ce2a6c_20250109T20:08_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. This is how may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling with Republic EMS. I was calling because I was needing to check claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, and I'm sorry, can I get your name one more time?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] OK, thank you. And may I have a callback number just in case we get disconnected, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It's 111-534-34.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] One moment
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] 52434.
[AGENT][NEUTRAL] Oh, OK, doesn't look like it's coming up. What's the name and date of birth?
[CUSTOMER][NEUTRAL] The first name, excuse me, is [PII].
[CUSTOMER][POSITIVE] Goodness, it's [PII]
[CUSTOMER][NEUTRAL] And the last name is [PII]
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, I'll have to do a name search because that policy number didn't pull that number, um, you said the policy you have is 11153434?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, yeah, that's too many numbers. Um, one moment, please.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] OK, um, and you said that it was hyphenated, correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Um, yeah, I'm not. Let me have the spelling of the first name one more time just to make sure I'm putting it correctly.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, [PII]. OK. And you said the last name is [PII]
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Let me change that.
[AGENT][NEUTRAL] All right, OK, uh, I think I found her.
[AGENT][NEUTRAL] Um, this one right here.
[AGENT][NEUTRAL] 1070, yes, that's correct. OK, and what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] The date of service is [PII].
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You guys are the secondary. Do you need the remaining balance or the full bill amount?
[AGENT][NEUTRAL] For bill amount.
[CUSTOMER][NEUTRAL] $2,419.26.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That was [PII], correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, I think it's gonna be this one. Yeah. What is the procedure code just to make sure that I'm looking at the right one.
[CUSTOMER][NEUTRAL] Um, it is A as in Alpha 0427.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, I found it. Um, and this member has a limited hospital indemnity plan, um.
[AGENT][NEUTRAL] So let me go ahead and tell you, it looks like it was denied, so let me see.
[AGENT][NEUTRAL] What's the reason?
[AGENT][NEUTRAL] All right, so we processed the claim on [PII] and um the denial reason for this is.
[AGENT][NEUTRAL] The policy does not provide benefits for ambulance expense.
[CUSTOMER][NEUTRAL] OK, um, I don't see that we received that denial. Is there any way to have that sent back out either in the mail or faxed?
[AGENT][NEUTRAL] I can fax it.
[CUSTOMER][POSITIVE] OK, that would be great.
[AGENT][NEUTRAL] OK, what's the fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, let me see.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] OK, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Um, I believe that that is all. Do you happen to have a fax number?
[AGENT][NEUTRAL] Uh fax number is our fax is [PII].
[CUSTOMER][POSITIVE] I'm, I'm so sorry.
[AGENT][NEUTRAL] Oh
[CUSTOMER][POSITIVE] A reference number. I'm so sorry.
[AGENT][NEUTRAL] OK. It's OK. No, we don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK perfect thank you so much for all your help.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good afternoon.
[CUSTOMER][NEUTRAL] You too