AccountId: 011433970860
ContactId: 84ff7864-3fea-4072-b97c-dd3fd9328fdd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215070 ms
Total Talk Time (AGENT): 53212 ms
Total Talk Time (CUSTOMER): 84225 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/84ff7864-3fea-4072-b97c-dd3fd9328fdd_20250409T15:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi. This is [PII] and I'm calling on behalf of the Piedmont Newton Hospital. I want to know the claim status.
[AGENT][NEUTRAL] Hey [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, my good callback number is [PII].
[AGENT][NEUTRAL] OK, and the policy number of the patient?
[CUSTOMER][NEUTRAL] Yeah, the policy number of the patient is 0259.
[CUSTOMER][NEUTRAL] 5117.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Yeah. The patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, do you have the date of service?
[CUSTOMER][NEUTRAL] Yeah, the date of service of the claim is uh [PII].
[AGENT][NEUTRAL] And the bill charges?
[CUSTOMER][NEUTRAL] Yeah, the total bill charges for the claim is $7,115 even.
[AGENT][POSITIVE] OK, thank you. Um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, it looks like we received the claim on.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] 224 [PII], it was processed the same day, [PII]. The benefit maximum for the uh benefit has been met.
[CUSTOMER][NEUTRAL] OK, so this claim has been denied for benefit maximum time passed and occurrence passed, right?
[CUSTOMER][NEUTRAL] So, I just want to know this this denial is the uh is in term of dollar.
[CUSTOMER][NEGATIVE] Hours, days, what exactly the denial.
[AGENT][NEUTRAL] Uh, it's $4. Let me check what that amount is.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, the max limit is $50.
[CUSTOMER][NEUTRAL] OK, the max amount is $50 right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what's your name? Could you please spell out your name once again?
[AGENT][NEUTRAL] Uh, it's [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And first initial to last name is [PII].
[CUSTOMER][NEUTRAL] OK, [PII], uh, I just want to confirm the remaining amount we need to, uh, sorry, so, OK, no issues, sir, no issues. So provide me the reference number as well.
[AGENT][NEUTRAL] It's my name, [PII], uh, first initial to [PII] name, [PII], today's date.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. Thanks for giving all the information regarding the claim and have a great day. Bye for now.
[AGENT][POSITIVE] Thanks for calling APL. You have a great day too.