AccountId: 011433970860
ContactId: b4106397-5400-49a0-85a8-9dc90268351b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266220 ms
Total Talk Time (AGENT): 122824 ms
Total Talk Time (CUSTOMER): 67735 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/b4106397-5400-49a0-85a8-9dc90268351b_20250129T16:21_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] [PII]'s [PII] how are you?
[AGENT][NEUTRAL] I can barely hear you. I'm sorry. What was your name?
[CUSTOMER][NEUTRAL] Can you hear me?
[AGENT][NEUTRAL] I can hear you now.
[CUSTOMER][NEUTRAL] [PII] is [PII]. How are you?
[AGENT][POSITIVE] I'm doing well, [PII]. How are you doing today?
[CUSTOMER][POSITIVE] I'm doing great, uh, [PII] I need to confirm claim status. Could you help.
[AGENT][POSITIVE] I would be happy to assist you, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] good callback number is [PII].
[CUSTOMER][NEUTRAL] [PII], it's a direct line.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Just give me a moment.
[CUSTOMER][NEUTRAL] It's 02505495.
[AGENT][NEUTRAL] And [PII], what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Alright thank you and it would be my pleasure to assist you with that claim information. Do you have the claim number or the date of service?
[CUSTOMER][NEUTRAL] Uh, the date of service is 7-23-2024. Bill amount is $300.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And what is the facility name please sir?
[CUSTOMER][NEUTRAL] It's Savan Primary care.
[AGENT][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] Checking on that claim for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] My pleasure.
[AGENT][NEUTRAL] And [PII], the last claim for that data service we received was on [PII].
[AGENT][NEGATIVE] Processed on [PII], it was denied as non-covered.
[AGENT][NEUTRAL] The outpatient treatment benefit provides an indemnity amount when a person receives treatment in an emergency room, urgent care facility, physician's office, uh, physical therapy fac facility, um,
[AGENT][NEUTRAL] Just
[AGENT][NEUTRAL] To let you know, treatment in an outpatient hospital less than 18 hours is not covered by this policy.
[CUSTOMER][NEUTRAL] OK. Could you provide me the policy name?
[AGENT][NEUTRAL] It is a hospital indemnity policy.
[CUSTOMER][NEUTRAL] Could you spell for me?
[AGENT][NEUTRAL] Sure, it's I as in India, N as in November, D as in Delta, E as in Echo, M as in Mike.
[AGENT][NEUTRAL] N as in November, I India, T Tango, Y Yankee.
[AGENT][NEUTRAL] Hospital indemnity. Mhm.
[CUSTOMER][NEUTRAL] Hospital.
[CUSTOMER][NEUTRAL] Uh, could you repeat this hospital in indemnity was just?
[AGENT][NEUTRAL] It does not cover outpatient hospital less than 18 hours.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Also, could you confirm what the
[CUSTOMER][NEUTRAL] The limit for the
[CUSTOMER][NEUTRAL] Creed claim
[AGENT][NEUTRAL] Not only filing for corrected claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Could you, uh,
[CUSTOMER][NEUTRAL] OK, could you provide me the call reference number, [PII]?
[AGENT][NEUTRAL] Oh reference number is.
[CUSTOMER][NEUTRAL] And also, could you provide me the claim number?
[AGENT][NEUTRAL] Sure, that claim number is 353.
[AGENT][NEUTRAL] 6167.
[CUSTOMER][NEUTRAL] It's 353-616-7.
[AGENT][NEUTRAL] Yes, sir, that's correct. And the call reference number is my name and today's date.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Perfect. Thank you, [PII], provide that information. Have a good day.
[AGENT][POSITIVE] It's been my pleasure to assist you, [PII]. Thank you for calling APL and I hope you have a wonderful day as well.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.