AccountId: 011433970860
ContactId: 93a22197-eb2a-4469-9fec-b6dd0873db44
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219600 ms
Total Talk Time (AGENT): 112842 ms
Total Talk Time (CUSTOMER): 44299 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/93a22197-eb2a-4469-9fec-b6dd0873db44_20250128T16:01_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I was calling to see if you received a claim.
[AGENT][NEUTRAL] Certainly [PII], I can help you with the claim inquiry. Can I please have uh your callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And are you calling from a facility today [PII] or hospital?
[CUSTOMER][NEUTRAL] Yes, uh, facility.
[AGENT][NEUTRAL] Can I have the name?
[AGENT][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Um, and midhealth.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Thank you for that and may I please have the policy certificate or member ID?
[CUSTOMER][NEUTRAL] 1514323
[AGENT][POSITIVE] Thank you, just give me one moment please.
[AGENT][NEUTRAL] And may I please have you verify patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you were checking on uh a claim status for [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me check some information one moment.
[AGENT][NEUTRAL] What is the uh claim data service and the amount, please?
[CUSTOMER][NEUTRAL] Um, [PII] for $7,0004 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now would this be the facility charges the tree?
[AGENT][NEUTRAL] From the hospital.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mm, yes, he was seen in the emergency room.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so I don't, uh, see your claim on file, um, for that data service, um, 82 2024 for $7,04. Um, I do not have that claim on file. Um, this policy is no longer active.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] The effective date was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it looks like the this participant was dropped on [PII].
[AGENT][NEUTRAL] Of [PII].
[AGENT][NEGATIVE] So they don't have any coverage after [PII].
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Not with us, um, however, I do not see your claim on file so if you needed to send it in to us for that denial, I can provide you our claims fax number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can fax that claim to us at 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][POSITIVE] All right [PII], thank you for your help. Is there a call reference number?
[AGENT][NEUTRAL] Certainly the call reference number you would use my name in today's date and it's [PII].
[AGENT][POSITIVE] My last initial L like love in today's date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you have any other questions?
[CUSTOMER][POSITIVE] Alright, thank you, ma'am for your help. No, ma'am, that was it. Thank you.
[AGENT][POSITIVE] Alright, thank you so much for calling [PII]. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye bye.