AccountId: 011433970860
ContactId: ba0e0415-c66c-4487-8998-eed9e0d68545
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236100 ms
Total Talk Time (AGENT): 89268 ms
Total Talk Time (CUSTOMER): 49256 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/ba0e0415-c66c-4487-8998-eed9e0d68545_20250106T16:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, my name is [PII]. I'm following up on a claim.
[AGENT][POSITIVE] All right, [PII]. I'm happy to check on a claim for you today. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, that would be 02.
[CUSTOMER][NEUTRAL] Followed by 4 consecutive 4.
[CUSTOMER][NEUTRAL] 88 L as in Lima.
[CUSTOMER][NEUTRAL] I'm sorry, that would be M as in Mary, L as in Lima, 8.
[AGENT][POSITIVE] Alright [PII], thank you for that. Let me pull this up and do you have a good call back number?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. What is the patient name and date of birth?
[CUSTOMER][NEUTRAL] That would be [PII] Age. Date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you and then date of service?
[CUSTOMER][NEUTRAL] Data services 528-2024.
[AGENT][NEUTRAL] OK, and then the bill amount.
[CUSTOMER][NEUTRAL] That'll be 7530 cents.
[AGENT][POSITIVE] OK, thank you so much. Let me just take a look here one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so it looks like we did receive the claim, uh, claim was denied. It looks like the maximum benefits for um hospital confinement had already been paid out.
[CUSTOMER][NEUTRAL] And what's the maximum?
[AGENT][NEUTRAL] Uh, let me go back and double check that. Give me one second here.
[AGENT][NEUTRAL] It looks like the inpatient uh benefit max for the year is $2000.
[CUSTOMER][NEUTRAL] OK, and that was paid to um to the hospital, to the facility?
[AGENT][NEUTRAL] It looks like yeah it's just saying it was denied the previous uh the maximum benefits for confinement had previously been paid, so there was nothing additional payable on this claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you need the claim number or anything?
[CUSTOMER][NEUTRAL] Um, yes, can I have the claim number?
[AGENT][NEUTRAL] Uh, the claim number is 35437007.
[CUSTOMER][NEUTRAL] I'm sorry, that was 354?
[AGENT][NEUTRAL] Uh-huh. 354-37007.
[CUSTOMER][NEUTRAL] OK, and the reference number for our card that is your last name?
[AGENT][NEUTRAL] Uh, the call reference is my name with my last initials in today's date. My name again is [PII], that's spelled [PII] The last initial to my name is [PII].
[CUSTOMER][POSITIVE] OK, perfect. OK, [PII], thank you very much for your help.
[AGENT][POSITIVE] You're welcome [PII] have a good day.
[CUSTOMER][NEUTRAL] You too bye.