AccountId: 011433970860
ContactId: 850f55da-905e-4e76-80c8-4fff24f9d9e9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242399 ms
Total Talk Time (AGENT): 88660 ms
Total Talk Time (CUSTOMER): 144389 ms
Interruptions: 10
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/850f55da-905e-4e76-80c8-4fff24f9d9e9_20250228T16:48_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you? Um, hello. So, this is [PII]. I'm calling on behalf of Mount Sinai Medical Center. I would like to check my status for one of our patients.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, sure, Ms. [PII], I can assist you with claims and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, callback number it is [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Yes, um, policy number, it is.
[CUSTOMER][NEUTRAL] 021
[CUSTOMER][NEUTRAL] 261
[CUSTOMER][NEUTRAL] 63
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry.
[CUSTOMER][NEUTRAL] 8.
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] May I have the name and date of birth of the patient? Yes, patient's name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Thank you. What is the date of service? Yes, date of service was [PII] and bills amount was $337 even.
[AGENT][NEUTRAL] OK, thank you. That's [PII] for 3:37. OK, let me see if I have that claim.
[CUSTOMER][NEUTRAL] OK, thank you. That's June 1724 for 37.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And Ms. [PII], for future you can check claim status online through our website at [PII], and that's just optional. You can always call.
[CUSTOMER][NEUTRAL] In the Sea for future you can check status online through our website at secure.
[AGENT][NEUTRAL] And let me call this ELB. You're welcome.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and I'm waiting on the ELB to upload, OK.
[CUSTOMER][NEUTRAL] And I'm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like we received the claim on [PII], processed [PII], and the claim was denied stating that office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] By [PII] and the claim was denied stating that office visits are not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It's because of the patients plan.
[AGENT][NEUTRAL] Mhm, yes, because of the patient's plan.
[CUSTOMER][NEUTRAL] Yes. What?
[CUSTOMER][NEUTRAL] What kind of plan does this patient have?
[AGENT][NEUTRAL] This is a secondary supplemental plan to the major medical, but this one doesn't cover office visits.
[CUSTOMER][NEUTRAL] the major medical but this one doesn't cover off.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And not cover of this visit. OK, so this um should be sent to the patient.
[AGENT][NEUTRAL] It's up to the provider's discretion.
[CUSTOMER][NEUTRAL] Mhm. OK. Can I have the claim number?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Sure, that's 3481939.
[CUSTOMER][NEUTRAL] Sure, that's 3481939.
[CUSTOMER][NEUTRAL] 193. OK, let me repeat it back to you so it's 3481939, correct?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] OK, thank you so much. So, um, can I have a reference number for this call?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will, Miss [PII].
[CUSTOMER][NEUTRAL] We don't have reference numbers. You can use my name in today.
[CUSTOMER][POSITIVE] OK, thank you so much, so you have a nice day. Thank you.
[AGENT][POSITIVE] You're welcome. You as well, Miss [PII] Thank you for calling APL. Have a good day. Bye bye.
[CUSTOMER][NEUTRAL] Bye.