AccountId: 011433970860
ContactId: 81616c72-2454-4d60-b7ab-0dcda3eafb1a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 377940 ms
Total Talk Time (AGENT): 108476 ms
Total Talk Time (CUSTOMER): 81444 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/81616c72-2454-4d60-b7ab-0dcda3eafb1a_20250318T17:48_UTC.wav
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[CUSTOMER][POSITIVE] Fashion a cool.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hold on, hold on.
[CUSTOMER][NEUTRAL] [PII], hi, it's [PII] from Yale medicine calling for a claim status.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with the claim status. Um, can you give me the name of the provider again, please?
[CUSTOMER][NEUTRAL] Ee medicine.
[AGENT][NEUTRAL] Thank you. And then what is your callback number just in case our call is disconnected?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And can I please get the patient's name, date of birth, and policy number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Sure, [PII]. Hope I didn't destroy that, um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] 2493498
[AGENT][NEUTRAL] 2493498. OK, let me pull up that policy.
[CUSTOMER][NEUTRAL] 98
[AGENT][NEUTRAL] Oh my. Chargeuni.
[CUSTOMER][NEUTRAL] Yeah, something.
[AGENT][NEUTRAL] Yeah, that's a hard, that's a hard name to say.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what is the date of service for the claim?
[CUSTOMER][NEUTRAL] Um, [PII], bill amount is 375.
[AGENT][NEUTRAL] OK, and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] 50.
[AGENT][NEUTRAL] 50 even OK on a brief hold, Miss [PII], while I look up this claim and I'll be right back.
[CUSTOMER][POSITIVE] OK, no problem. Thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] A trophy to put our foot in it.
[AGENT][NEUTRAL] OK, Ms. [PII].
[AGENT][NEUTRAL] This is Tory back with you again. I have the claim number. It is 3551213 and the claim was denied because office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. When was it denied?
[AGENT][NEUTRAL] Uh, let me let you know. Let me look it up real quick.
[AGENT][NEUTRAL] Uh, we received it on [PII] and processed it on [PII].
[CUSTOMER][NEUTRAL] OK, my last question, are you able to email me or fax me a copy of the denial?
[AGENT][NEUTRAL] Yes, I can fax it to you. What's your fax number?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And please put it to my attention.
[AGENT][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, I will and I'm gonna put you on a brief hold so I can get that taken care of while we're on the phone together.
[CUSTOMER][NEUTRAL] OK. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, Ms. [PII]. I've got that fax on its way to you now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, um, [PII], right?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] [PII], oh, [PII], OK. Thank you so much.
[AGENT][NEUTRAL] Yes. Yes, ma'am.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. I hope you have a wonderful day. Is there anything else I can help with before we go?
[CUSTOMER][POSITIVE] Um, no, that's it. Thank you.
[AGENT][POSITIVE] Alright, well you take care and thanks for calling APL.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye-bye.