AccountId: 011433970860
ContactId: b3d9c19c-81e0-42e3-8176-9b0dc9e7ace7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228779 ms
Total Talk Time (AGENT): 84857 ms
Total Talk Time (CUSTOMER): 75978 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/b3d9c19c-81e0-42e3-8176-9b0dc9e7ace7_20250613T12:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning. My name is [PII]. I'm calling from Upton Regional Medical Center, and I was calling to find out on behalf of a patient, find out if you, if y'all received a bill yet.
[AGENT][NEUTRAL] OK. Yeah, we can take a look for a claim. Let's see. uh, what is the patient policy number? Do you have that?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, it's D 476 8.
[CUSTOMER][NEUTRAL] 8511.
[AGENT][NEUTRAL] OK. I unfortunately, [PII] can't pull them with that number. Do you have their name or social? We can try with that.
[CUSTOMER][NEUTRAL] Um, I have social for [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Let me.
[AGENT][NEUTRAL] 01 moment.
[AGENT][NEUTRAL] What is the insured's first and last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And then date of birth.
[CUSTOMER][NEUTRAL] Um, date of birth is [PII].
[AGENT][NEUTRAL] OK, and then what's the data service we're looking for?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, and then do we have a bill amount?
[CUSTOMER][NEUTRAL] Um, 11,000.
[CUSTOMER][NEUTRAL] $415.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] OK, so it looks like we did get the claim. It looks like it was denied. It does state that the medical test given for the state of service is not a covered diagnostic test, therefore, no benefit is payable.
[CUSTOMER][NEUTRAL] OK, and you said it was denied due to repeat the first part again? I'm sorry, this is my first time doing this.
[AGENT][NEUTRAL] No, that's OK. That's OK. Uh, the medical test that was given on the date of service.
[AGENT][NEUTRAL] is not a covered diagnostic test.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] The diagnosis. OK. There will test that was given date of service.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Not a covered diagnostic test.
[CUSTOMER][NEUTRAL] Gotcha. OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Already thank you so much.
[AGENT][NEUTRAL] And then, do you need a
[AGENT][POSITIVE] Yeah, not a problem. Anything else I can help with?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, what was your name? I guess I need to get that.
[AGENT][NEUTRAL] No, no worries. My name is [PII], that's [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and make sure there's anything.
[CUSTOMER][NEUTRAL] Oh, in reference number.
[AGENT][NEUTRAL] OK, absolutely. So you can use my name with today's date as a call reference, so [PII] and then [PII].
[CUSTOMER][NEUTRAL] 6.
[CUSTOMER][POSITIVE] OK, alright, thank you so much I appreciate it.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye.