AccountId: 011433970860
ContactId: 4cadbcf9-9501-4a64-b722-73fe8a9725e9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192089 ms
Total Talk Time (AGENT): 83268 ms
Total Talk Time (CUSTOMER): 72747 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/4cadbcf9-9501-4a64-b722-73fe8a9725e9_20241230T19:18_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for call or good afternoon. Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], I have a provider on the back line that's inquiring about an insured's policy. Um, she recently received a denial from us and she's just wanting to verify the details on the denial and make sure the patient's responsible for the, I guess, balance.
[AGENT][NEUTRAL] OK, what is that policy number?
[CUSTOMER][NEUTRAL] 256-4040
[CUSTOMER][NEUTRAL] It's [PII], and I did verify everything. Provider's name is [PII].
[CUSTOMER][NEUTRAL] And the callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 71
[CUSTOMER][NEUTRAL] 28.
[AGENT][NEUTRAL] OK, and what's the provider's name?
[CUSTOMER][NEUTRAL] She said her name was [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, ma'am. That's the way I spelled it.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] All right, here she goes.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yeah, uh-huh.
[AGENT][NEUTRAL] Um, do you spell your name, how do you spell your name?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] OK, [PII]. OK. OK. And what, and you're calling uh for to get an explanation of a denial?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And what is that date of service?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Data services [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me one minute, I'll be happy to look that, look at that claim and give you the reason of the, explain the denial.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Uh, this policy does not cover any, uh, diagnostic tests. Um, there's no, and this is considered as a diagnostic. Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] So that it was denied as um not payable due to, it was um not a covered diagnostic test.
[CUSTOMER][NEUTRAL] Benefits.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And so the the the remainder amount, it will be the patient's responsibility.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, well, you all didn't pay anything, so the whole amount is just responsibility, is that correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Can you give me your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII], is there um a reference number for the call?
[AGENT][NEUTRAL] You can just use my name on today's date.
[CUSTOMER][POSITIVE] Alrighty great thank you so much [PII] for your help and you have a great day.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] You're welcome. Anything else I can help you out with, Miss [PII]?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK, well you have a wonderful day and thank you for calling the American Public Life.
[CUSTOMER][NEUTRAL] OK you too bye now.
[AGENT][POSITIVE] Thank you. Goodbye.