AccountId: 011433970860
ContactId: 508e3c23-90a7-430c-866e-8ec39edc4228
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 357220 ms
Total Talk Time (AGENT): 123877 ms
Total Talk Time (CUSTOMER): 120887 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/508e3c23-90a7-430c-866e-8ec39edc4228_20250131T17:17_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Community Memorial Hospital to check on the claim status. Sorry, can you please repeat your name?
[AGENT][NEUTRAL] Sure, [PII]. My name is [PII].
[AGENT][NEUTRAL] And [PII], what is a good callback number?
[CUSTOMER][NEUTRAL] Hi, [PII].
[CUSTOMER][NEUTRAL] Hi, [PII]. How are you? And my contact number is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] And [PII], it would be my pleasure to assist you. You're needing claim status, correct?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Yes. Thank you.
[AGENT][POSITIVE] All right. My pleasure. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Policy number ID is 01984-477 M as in Mike.
[CUSTOMER][NEUTRAL] L as in Lima, and 8.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yeah, I
[CUSTOMER][NEUTRAL] Yeah, sure. The name is
[CUSTOMER][NEUTRAL] [PII], and the last name is [PII]. And the date of birth is on [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And I can help you with that claim status. What is that data service?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you. 3102.
[AGENT][NEUTRAL] I, do you have that data service for the claim?
[CUSTOMER][NEUTRAL] Yes. The date of service is on [PII]. And do you want to fill them out?
[AGENT][POSITIVE] Yes, yes, please.
[CUSTOMER][NEUTRAL] Yes, sure. The bill amount is $244 even.
[AGENT][NEUTRAL] And what is the facility name, please?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The facility name as Community Memorial Hospital.
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] So you have that.
[AGENT][NEUTRAL] Uh, I think we did receive that claim on [PII].
[CUSTOMER][NEUTRAL] Yeah, I
[AGENT][NEUTRAL] The claim was denied on [PII].
[CUSTOMER][NEUTRAL] Sorry, can you please repeat once more the received date?
[AGENT][NEUTRAL] Received date [PII].
[CUSTOMER][NEUTRAL] And the process date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Dinner rate is same, right?
[AGENT][NEUTRAL] Uh, the receipt date was [PII]. The process date [PII].
[CUSTOMER][NEUTRAL] And may I know the date?
[AGENT][NEUTRAL] The denial date is [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much for the confirmation.
[CUSTOMER][NEUTRAL] May I know the reason?
[AGENT][NEGATIVE] That was denied because services were surrendered after the policy turned.
[AGENT][NEUTRAL] The policy termed on 10-1-2024.
[CUSTOMER][NEUTRAL] OK. The patient is not active in the state of service, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] May I know the patient's effective and term please?
[AGENT][NEUTRAL] Effective date [PII].
[AGENT][NEUTRAL] And term date on [PII].
[CUSTOMER][NEUTRAL] Uh, the date, uh, uh, mm, OK.
[AGENT][NEUTRAL] Would you like the claim number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The claim number is 354.
[AGENT][NEUTRAL] 9495.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for the information, [PII].
[CUSTOMER][NEUTRAL] May I know patient have any other insurance?
[AGENT][NEUTRAL] Not with APL. You would need to check with the insured.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for the information, [PII]. May I know the contact number?
[AGENT][NEUTRAL] The reference number is my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] But.
[AGENT][POSITIVE] It's been a pleasure to assist you with that claim status, [PII]. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Thank you so much for the information, [PII]. I really appreciate your patience and assistance. Have a great day. Bye-bye.
[AGENT][POSITIVE] I hope you have a great day as well. [PII] thank you for calling ATL and have a happy weekend also.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] OK