AccountId: 011433970860
ContactId: c0fdde97-6abd-47ce-845d-990ce0cd8667
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225470 ms
Total Talk Time (AGENT): 101451 ms
Total Talk Time (CUSTOMER): 73290 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/c0fdde97-6abd-47ce-845d-990ce0cd8667_20250210T21:20_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and I am calling with Jackson Madison County General Hospital for claim status.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Can you spell your name for me?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure. My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hey Ms. [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] That is 02502056.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] a
[CUSTOMER][NEUTRAL] I'm gonna spell the first name because I don't want to butcher it. [PII] Last name is [PII].
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Thank you. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] [PII] for $38,387.
[AGENT][NEUTRAL] All right. Let me see if I can find this claim for you, and that was [PII], correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] And Miss [PII], for future, you can check claim status online through our website at [PII] and that's just optional.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Yeah
[AGENT][NEGATIVE] It looks like we received a claim [PII], and we processed the claim [PII], um, and the claim was denied, and the reason for this denial is that our records indicate that the premium for the date of service was not received, therefore benefits are not payable.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK, the what wasn't received?
[AGENT][NEGATIVE] The premium for the date of service was not received. Mhm. Yes, the policy terminated.
[CUSTOMER][NEUTRAL] Bring him.
[CUSTOMER][NEUTRAL] OK, and what day did it terminate on?
[AGENT][NEUTRAL] OK, this policy was terminated [PII].
[CUSTOMER][NEUTRAL] OK, and do you happen to have a call reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do um do you need any other information, Ms. [PII]?
[CUSTOMER][NEUTRAL] No, ma'am, that is it.
[AGENT][POSITIVE] OK. Well, thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.