AccountId: 011433970860
ContactId: 8197957d-ec16-4983-bdad-5f34d695f59c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 222229 ms
Total Talk Time (AGENT): 72572 ms
Total Talk Time (CUSTOMER): 65017 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/8197957d-ec16-4983-bdad-5f34d695f59c_20250418T13:36_UTC.wav
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[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi Ms. [PII], my name is [PII]. Last initial [PII], and I'm hoping you could help me, uh, with the claim denial, figure out why it denied.
[AGENT][NEUTRAL] Yeah, [PII], I can help you with claim status today. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] It is 123.
[CUSTOMER][NEUTRAL] 5013.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And then what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK, and then patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK OK and then do you have a claim number?
[CUSTOMER][NEUTRAL] Um, 344-759-8.
[AGENT][POSITIVE] OK perfect.
[AGENT][NEUTRAL] OK, just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so it looks like we received this claim for [PII].
[AGENT][NEUTRAL] And then the process date is [PII].
[AGENT][NEUTRAL] And then what provider's office are you calling from?
[CUSTOMER][NEUTRAL] Um, yes, it is Christa Shreveport Bossier Health System.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, so it looks like this claim was denied.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEGATIVE] And it's due to this policy does not provide a benefit for sur surgical procedures.
[CUSTOMER][NEUTRAL] Um, say that again, policy does not provide.
[AGENT][POSITIVE] A benefit.
[AGENT][NEUTRAL] For
[AGENT][NEUTRAL] Surgical procedures.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][POSITIVE] Perfect. That's what I needed to know. So you said it was received on [PII] and processed and denied on [PII].
[AGENT][POSITIVE] Yes, correct. Mhm.
[CUSTOMER][POSITIVE] OK, perfect. OK. All right, [PII], that answers my question and
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Yeah. All right, Ms. [PII] and whenever you're ready, I will get a reference number from you.
[AGENT][NEUTRAL] Yeah, of course. So it's my first name. Um, it's spelled [PII]
[AGENT][NEUTRAL] Last initial [PII]
[AGENT][NEUTRAL] And then today's date.
[CUSTOMER][POSITIVE] Perfect thank you so much. Hope you have a great Friday and happy Easter.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Thank you you too. Thanks for calling APL.
[CUSTOMER][NEUTRAL] Uh-huh. Bye-bye.
[AGENT][NEUTRAL] All right. Bye.