AccountId: 011433970860
ContactId: 974f76f6-6463-4dff-8383-b74682735cc0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 265040 ms
Total Talk Time (AGENT): 82358 ms
Total Talk Time (CUSTOMER): 94415 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/974f76f6-6463-4dff-8383-b74682735cc0_20250331T12:21_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, my name is [PII], and I'm calling from the business office of Mount Sinai Medical Center in [PII]. I was calling to follow up on a, uh, a claim from [PII] that we didn't have a response on for secondary payment.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's uh it's a direct line and it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] OK. Uh, policy number is 022884992.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] and that is spelled [PII], last name [PII]
[CUSTOMER][NEUTRAL] And date of birth I have is [PII].
[AGENT][NEUTRAL] OK, let's see. And the date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And it was $5,209.74.
[AGENT][NEUTRAL] OK. Thank you. One moment, I'm waiting on my system.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK. Yes, ma'am. Thanks for your patience. Um, we received this claim on [PII].
[AGENT][NEUTRAL] And it was processed on.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] [PII].
[AGENT][NEGATIVE] And it actually denied, let me get the denial reason. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, denied because according to the diagnosis on the claim, um it was related to intoxication or narcotics, which is not covered under the policy.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All righty. um, I, is there a claim number or anything like that?
[AGENT][NEUTRAL] Um, yes, ma'am. The claim number is.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, 344-761-1.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] I really appreciate it. Um, last question, E, is there any way to get a copy of that?
[AGENT][NEUTRAL] Um, yes, ma'am. I can fax the explanation of benefits to you. What's your fax number, please?
[CUSTOMER][NEUTRAL] Uh, sure. Uh, it's gonna be [PII].
[AGENT][NEUTRAL] OK, so that's attention, [PII] [PII].
[CUSTOMER][POSITIVE] That's correct. Yes, ma'am.
[AGENT][NEUTRAL] OK. You should receive it in about 10 minutes. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] They should.
[CUSTOMER][POSITIVE] Oh no, that's more than enough, [PII]. Thank you so much. I appreciate you. Is there a call reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much. Appreciate it. Have a good day.
[AGENT][POSITIVE] OK, thank you again. You do the same. Thank you again, [PII], for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.