AccountId: 011433970860
ContactId: 43101748-2769-4dfe-b746-aa72acb2617f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 387859 ms
Total Talk Time (AGENT): 128799 ms
Total Talk Time (CUSTOMER): 57307 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/43101748-2769-4dfe-b746-aa72acb2617f_20250401T20:44_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi. My name is [PII] calling from Mercy Hospital for checking on claims.
[AGENT][NEUTRAL] Hey [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes, it is.
[AGENT][NEUTRAL] Yes, I can help you with that, [PII]. And what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] 21
[AGENT][NEUTRAL] OK. I can help you with that. And what is that member's policy number, please?
[CUSTOMER][NEUTRAL] May I proceed with the member ID number?
[AGENT][NEUTRAL] I need the member's policy number.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, policy ID is 02134924.
[AGENT][NEUTRAL] Thank you one moment please, [PII], while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And any information, [PII] that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth, please?
[CUSTOMER][NEUTRAL] Yeah, my first name is [PII].
[CUSTOMER][NEUTRAL] [PII]. Date of birth of [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] What is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Yeah, for the data service, it's uh
[CUSTOMER][NEUTRAL] Yes, for [PII].
[AGENT][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] Yeah, no [PII]. And the total charge for the claim is for 1000.
[CUSTOMER][NEUTRAL] $921 even.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, just a moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so this claim was received.
[AGENT][NEUTRAL] The received date was [PII].
[AGENT][NEGATIVE] It was processed and denied on the same date.
[AGENT][NEUTRAL] The claim number is 3550183.
[CUSTOMER][NEUTRAL] Ma'am, could you please start to, start out with the claim number?
[AGENT][NEUTRAL] 3550183.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And this was denied. The reason for the denial states the patient is no longer an eligible dependent under this policy.
[CUSTOMER][NEUTRAL] Uh, may I know the member's policy on term get?
[AGENT][NEUTRAL] One moment. The effective date is [PII].
[AGENT][NEUTRAL] And this particular participant, just a moment.
[AGENT][NEUTRAL] Coverage terminated for [PII].
[CUSTOMER][NEUTRAL] Yeah, let me just have a look for the number of visits.
[CUSTOMER][NEUTRAL] Please have a look, ma'am.
[AGENT][NEUTRAL] I'm sorry, what are you asking me?
[CUSTOMER][NEUTRAL] Yeah. Kindly allow me for a couple of seconds.
[AGENT][NEUTRAL] Uh-huh. You're OK.
[CUSTOMER][NEUTRAL] Yeah, and uh can I get the call number?
[AGENT][NEUTRAL] Yes, the call reference number would be my name along with today's date.
[AGENT][NEUTRAL] And if you need a copy of this explanation of benefits, [PII], you may print that by going to our portal at [PII].
[AGENT][NEUTRAL] And is there anything else I can help you with?
[CUSTOMER][POSITIVE] Nothing sir for that time, ma'am. Thank you so much. And your name is?
[AGENT][NEUTRAL] OK, well, you're welcome. My name is [PII].
[CUSTOMER][POSITIVE] Yeah, thank you so much.
[AGENT][POSITIVE] You're very welcome. So again, if that is all I can help you with, thank you for calling APL [PII] and I hope you have a nice rest of your day.
[CUSTOMER][POSITIVE] Yeah, thank you so much.
[AGENT][POSITIVE] You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah.