AccountId: 011433970860
ContactId: 521d9f8d-e97a-4872-b404-57892a0f6ea1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166940 ms
Total Talk Time (AGENT): 45608 ms
Total Talk Time (CUSTOMER): 45583 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/521d9f8d-e97a-4872-b404-57892a0f6ea1_20250417T14:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from University Hospital's Medical Group in regards to a claim denial.
[AGENT][NEUTRAL] OK, [PII], I can help you with that claim status. Do you have a good callback number, please?
[CUSTOMER][NEUTRAL] My direct line is [PII].
[AGENT][NEUTRAL] And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] It's 02566961.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] OK, and what was that date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the bill charges?
[CUSTOMER][NEUTRAL] $383.
[AGENT][NEUTRAL] Um, do you have the claim number?
[CUSTOMER][NEUTRAL] Um, I can get it one second.
[AGENT][NEUTRAL] It looks like we've got a few claims. I was just seeing which one you were.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] It is showing as.
[CUSTOMER][NEUTRAL] 356-669-5
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That was the duplicate. Let me look at the original.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Uh, it looks like the original claim we had denied for outpatient services not covered under policy.
[CUSTOMER][NEUTRAL] OK, and that's patient responsibility?
[AGENT][NEUTRAL] Um, this is a supplemental policy, so we don't determine patient responsibility. We just process according to the plan.
[CUSTOMER][NEUTRAL] Oh, it's a supplement.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, look at that. I'm getting all sorts of answers. OK. Is there a call reference number?
[AGENT][NEUTRAL] Um, it's my name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much for your help.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.