AccountId: 011433970860
ContactId: a28dfbf5-ae76-412c-8803-bc1f3349ee4d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 257170 ms
Total Talk Time (AGENT): 95295 ms
Total Talk Time (CUSTOMER): 65647 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/a28dfbf5-ae76-412c-8803-bc1f3349ee4d_20250203T18:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Parkview. I was calling to get an update on a patient's claim, please.
[AGENT][NEUTRAL] OK, you're calling on behalf of whom?
[CUSTOMER][NEUTRAL] Park View Hospital.
[AGENT][NEUTRAL] Parkview, OK.
[AGENT][NEUTRAL] And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Um, 022-76561.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Alright, thanks for that information and did you say you're checking claim status or eligibility?
[CUSTOMER][NEUTRAL] Claim status please.
[AGENT][NEUTRAL] OK, I can get the date of service in charge I can assist.
[CUSTOMER][NEUTRAL] Uh, [PII] for $292.50.
[AGENT][NEUTRAL] And this is a medical claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Now, you did say Park View Hospital. All right.
[AGENT][NEUTRAL] Alright, so show this claim was processed on [PII].
[AGENT][NEUTRAL] Uh, there was no payment made on this claim.
[AGENT][NEUTRAL] And the remarks cites that.
[AGENT][NEUTRAL] The diagnostic test submitted is not covered under this policy.
[AGENT][NEGATIVE] And it looks like we did receive it a second time, uh, how, however, it denied as a duplicate.
[AGENT][NEUTRAL] To the previous one.
[CUSTOMER][NEUTRAL] OK, can I get the claim number?
[AGENT][NEUTRAL] Uh huh, it's 349-065-6.
[AGENT][NEUTRAL] That's the original.
[CUSTOMER][NEUTRAL] And are you able to, OK, are you able to email or fax a copy of the EOB?
[AGENT][NEUTRAL] We actually mailed it to the address that's on the claim when it was processed, uh, [PII], and it is now available to download on the online service center um at secured.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you can download it using that claim number?
[CUSTOMER][NEUTRAL] OK, so we don't have access to download this portal and use the portal you can't mail a copy of the EOB because we don't have one on file.
[AGENT][POSITIVE] No, I can fax it. I was just offering the online portal because it's an easy access.
[CUSTOMER][NEUTRAL] OK, yeah, we have to go, we have to go through a security process with our IT department in order to get it a web address added that we don't already have, so it'll be easier if it could just be emailed or fax [PII].
[AGENT][NEUTRAL] OK, what's the fax number? OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And is this directly to you?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. [PII]?
[CUSTOMER][NEUTRAL] Yes, and my first name is [PII]
[AGENT][NEUTRAL] OK, alright, [PII], we'll get that over to you allow 24 hours could be before then, but at least 24 hours, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you [PII]. Do you guys do call reference numbers?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference. [PII], first initial with of my last name is [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, thanks [PII] I appreciate your time and your help.
[AGENT][POSITIVE] Oh, you're welcome. Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.