AccountId: 011433970860
ContactId: 9107c900-066f-4d13-aca1-c2fa294e82d7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 357350 ms
Total Talk Time (AGENT): 104736 ms
Total Talk Time (CUSTOMER): 70534 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/9107c900-066f-4d13-aca1-c2fa294e82d7_20250604T15:28_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, my name is [PII]. Is this the correct line to talk about claims?
[AGENT][NEUTRAL] For claims, yes, um, can I get your name one more time?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII], um,
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Can I get a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh, it's [PII]. I'm sorry, [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] Policy number is.
[CUSTOMER][NEUTRAL] 02608115
[AGENT][NEUTRAL] Give me just a moment to look that up.
[CUSTOMER][NEUTRAL] Try to take your time.
[AGENT][NEUTRAL] Can you please verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] And do you have the claim number or date of service on file?
[CUSTOMER][NEUTRAL] I have a data service [PII] charge amount $2,908.08.
[AGENT][NEUTRAL] OK, give me just a moment to look that up.
[AGENT][NEUTRAL] And what is the provider's name or the hospital name?
[CUSTOMER][NEUTRAL] Uh, Spiedmont Newan Hospital.
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] It looks like we received this claim on [PII].
[AGENT][NEUTRAL] The claim was processed on [PII].
[AGENT][NEUTRAL] The claim number is 3591243.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEGATIVE] It looks like this claim was denied. The outpatient rider only allows payments for outpatient surgery in an outpatient hospital or physician office. Uh, therefore, no benefits are payable.
[CUSTOMER][NEUTRAL] Just have no call. Do you have the UB?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, it looks like we sent the EOB to the Piedmont Noonan Hospital. Were you needing that faxed?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what's a good fax number?
[CUSTOMER][NEUTRAL] It's 847.
[CUSTOMER][NEUTRAL] 3803962
[AGENT][NEUTRAL] OK, and to confirm, I have 847.
[AGENT][NEUTRAL] 3803962, correct?
[CUSTOMER][NEUTRAL] Uh, yes, and could you use attention as.
[CUSTOMER][NEUTRAL] 12406216
[AGENT][NEUTRAL] OK, one more time. Attention to what?
[CUSTOMER][NEUTRAL] 12406216.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I just sent that fax over.
[CUSTOMER][NEUTRAL] OK. And what's the initial of your last name?
[AGENT][NEUTRAL] Uh the last, uh, my name is [PII], last initial, [PII].
[CUSTOMER][NEUTRAL] And uh what's the reference number?
[AGENT][NEUTRAL] So we don't have reference numbers but you can use my name and last initial and today's date.
[CUSTOMER][POSITIVE] OK, thank you for the information. You have a great day.
[AGENT][POSITIVE] Great, thank you for calling APL. If there's nothing else, I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye.