AccountId: 011433970860
ContactId: 6b1162f2-cf6c-412f-b3a7-609df9403b54
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 309619 ms
Total Talk Time (AGENT): 86194 ms
Total Talk Time (CUSTOMER): 86792 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/6b1162f2-cf6c-412f-b3a7-609df9403b54_20250429T14:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm trying to confirm if the claim is on file.
[AGENT][POSITIVE] Of course, I can help you with claim status today.
[AGENT][NEUTRAL] Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Sorry, I had started doing.
[AGENT][NEUTRAL] Yeah, it's OK.
[CUSTOMER][NEUTRAL] OK, so it is 02584454.
[AGENT][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and then what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK. And then can you verify your first and last name, please?
[CUSTOMER][NEUTRAL] Yes, [PII], that's [PII].
[AGENT][NEUTRAL] And are you calling from a provider's office?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. So, can you verify the patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] Yes, [PII], and I don't know if it's which one is the first class. [PII], for sure.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then do you have a data service and a charge amount?
[CUSTOMER][NEUTRAL] Yes, 3 1925.
[CUSTOMER][NEUTRAL] And it's for $1,992.59.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, so I found that claim on file. Would you like that claim number?
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] OK, the claim number is 359.
[AGENT][NEUTRAL] 4341.
[AGENT][NEUTRAL] And it looks like the received date is [PII] and the process date is [PII].
[AGENT][NEUTRAL] And this claim was denied. Let's see.
[AGENT][NEUTRAL] OK, so it looks like treatment in an outpatient hospital is not covered by this policy.
[CUSTOMER][NEUTRAL] Oh, OK. Is this like this with this, I thought I heard that there was an indemnity plan.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and, and is this a supplement on indemnity plan or just uh.
[AGENT][NEUTRAL] Yes, it's just
[CUSTOMER][NEUTRAL] You guys are showing as the primer.
[AGENT][NEUTRAL] Yes, it's supplemental.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] So that means they have somebody.
[CUSTOMER][NEUTRAL] That's primary.
[AGENT][POSITIVE] Yes, they should.
[CUSTOMER][NEUTRAL] OK, well that's fine. They didn't provide that. They only provided you guys. Let's see, but even if they did, like you said, it doesn't cover outpatient.
[AGENT][POSITIVE] No, ma'am. That's correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, yes. Mhm.
[CUSTOMER][POSITIVE] OK great well thank you very much.
[AGENT][POSITIVE] Yeah, of course, is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, no, you wouldn't happen to know who the primary is.
[AGENT][NEUTRAL] No, I do not. Sorry.
[CUSTOMER][POSITIVE] Oh OK great well thank you very much you have a great day.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, thanks for calling EPL you too.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] All right, bye.