AccountId: 011433970860
ContactId: 5400614c-e4ae-4a18-a722-04728e8787ee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 314200 ms
Total Talk Time (AGENT): 85530 ms
Total Talk Time (CUSTOMER): 87525 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/5400614c-e4ae-4a18-a722-04728e8787ee_20250618T13:58_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] [PII], hi, I want to check status from the claim.
[AGENT][NEUTRAL] OK. May I ask who's calling?
[CUSTOMER][NEUTRAL] This is [PII] from Holy Cross Hospital.
[AGENT][NEUTRAL] And do you have a phone number where I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] direct.
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] The policy number I have is.
[CUSTOMER][NEUTRAL] Um, 02218491 ML 7.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 1 [PII] is his birthday.
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] Who, who am I speaking to?
[AGENT][NEUTRAL] And your name.
[AGENT][NEUTRAL] This is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you were needing claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can help you with that. What date of service?
[CUSTOMER][NEUTRAL] Data service is 224.
[CUSTOMER][NEUTRAL] Uh, for
[CUSTOMER][NEUTRAL] $122,395.59.
[AGENT][NEUTRAL] 224, 25.
[CUSTOMER][NEUTRAL] 24, 224 24.
[AGENT][NEUTRAL] 24.
[AGENT][NEUTRAL] OK. Hold on one moment.
[AGENT][NEUTRAL] OK, we did get that claim in.
[AGENT][NEUTRAL] Let's see, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was denied they had met their impatient Max.
[CUSTOMER][NEUTRAL] So you received this claim on what day?
[AGENT][NEUTRAL] Hold on just a moment and I can tell you.
[AGENT][NEUTRAL] 281
[AGENT][NEUTRAL] 55 of 25.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And process on what day?
[AGENT][NEUTRAL] 56 of 25.
[CUSTOMER][NEUTRAL] The claim number.
[AGENT][NEUTRAL] 359-828-1.
[CUSTOMER][NEUTRAL] And you said the claim denied for what reason?
[AGENT][NEUTRAL] Impatient Max Mitt.
[CUSTOMER][NEUTRAL] And patience.
[CUSTOMER][NEUTRAL] Inpatient, uh, what?
[AGENT][NEUTRAL] Maximum.
[AGENT][NEUTRAL] Met
[CUSTOMER][NEGATIVE] I don't, so what do that mean? We're not gonna get paid on this or um.
[AGENT][NEUTRAL] No, ma'am, they had met their maximum. They only get $5000 per calendar year, and we have already paid that out on previous claims.
[CUSTOMER][NEUTRAL] Only get get
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Right out already.
[CUSTOMER][NEUTRAL] Um, previous.
[CUSTOMER][NEUTRAL] OK. OK, we haven't received the EOB. Could you send me an EOB?
[AGENT][POSITIVE] Yes, ma'am. I can fax it to you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What's your fax number?
[CUSTOMER][NEUTRAL] Let me know when you're ready.
[CUSTOMER][NEUTRAL] The fax number is [PII].
[AGENT][NEUTRAL] OK, I'll fax it to you. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] I just need a reference for the call.
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] What's your last initial [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] How long should I wait for the EOB to be sent?
[AGENT][NEUTRAL] Probably about 10 minutes.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Thank you, [PII] for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] All right, bye.
[AGENT][POSITIVE] Thank you. Bye bye.