AccountId: 011433970860
ContactId: 6f404263-f774-4c77-ad74-85a901783ecf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203110 ms
Total Talk Time (AGENT): 84993 ms
Total Talk Time (CUSTOMER): 50831 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/6f404263-f774-4c77-ad74-85a901783ecf_20241230T18:01_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I'm with Ensemble Health Partners, and I was just checking on the status of a claim for a patient. Can you help me with that?
[AGENT][NEUTRAL] I can, and may I have your name again?
[CUSTOMER][NEUTRAL] [PII], last initials [PII]
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Thank you, [PII] and my last initial is [PII]. May I also have your callback number if we are disconnected please?
[CUSTOMER][NEUTRAL] [PII] and you say your name was [PII]?
[AGENT][NEUTRAL] No, my name is [PII].
[CUSTOMER][NEUTRAL] [PII], I'm sorry.
[AGENT][POSITIVE] No problem, no problem.
[CUSTOMER][NEUTRAL] Look I'm making up names.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] May I have the policy number please, [PII]?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It is 024909997.
[AGENT][POSITIVE] OK, thank you so much and let me just repeat that to confirm. I have that as 024909997.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Thank you and verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], date of birth of [PII].
[AGENT][POSITIVE] OK, thank you so much for that information. I have that number pulled up and you're calling to check claim status. I can assist you with that. And if you could please provide me with that date of service and the total charges, please.
[CUSTOMER][NEUTRAL] Yes, it is data of service.
[CUSTOMER][NEUTRAL] [PII] and the amount of $553.
[AGENT][NEUTRAL] OK, thank you so much, and that was [PII] for the charges of $553 even. One moment.
[CUSTOMER][NEUTRAL] And 50 cents.
[AGENT][POSITIVE] And 50 cents. I'm sorry. Thank you very much for that.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, I show the claim here. Thank you so much for your patience. Let me get those claim details for you, one moment.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And it shows that the claim was received and denied as anesthesia is not a covered benefit under this policy.
[CUSTOMER][NEUTRAL] OK. And, um, and is he still active on this policy?
[AGENT][NEUTRAL] Let me check that for you.
[AGENT][NEUTRAL] No, this quite, sorry, this policy has change, excuse me, excuse me, this policy has termed as of [PII].
[CUSTOMER][POSITIVE] OK, alright, I appreciate your help with this, [PII]. Is there a call reference number?
[AGENT][NEUTRAL] You're welcome, [PII]. We do not provide call reference numbers. Please use my name in today's date. Anything else I can help you with, please?
[CUSTOMER][POSITIVE] That's all. Thank you. Have a good one.
[AGENT][POSITIVE] You as well, and thank you for calling APL. Take care bye.
[CUSTOMER][NEUTRAL] You too bye.