AccountId: 011433970860
ContactId: c1cf4890-89a6-4d6c-92c3-2005a4c4d06f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210070 ms
Total Talk Time (AGENT): 70037 ms
Total Talk Time (CUSTOMER): 49257 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/c1cf4890-89a6-4d6c-92c3-2005a4c4d06f_20250106T13:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I apologize I didn't get your name.
[AGENT][NEUTRAL] Um, my name is [PII]. Um, it's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] Yes, this is [PII] I wasn't sure exactly which um.
[CUSTOMER][NEUTRAL] Option to choose I'm calling on behalf of Saint Francis Anesthesia in reference to a claim we submitted.
[AGENT][NEUTRAL] Um, sure, [PII], I can assist you with claim status. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Yes, let me get back to that.
[CUSTOMER][NEUTRAL] 02504582
[AGENT][NEUTRAL] Thank you and please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Mac [PII] [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, now I need the date of service and bill charges for the claim.
[CUSTOMER][NEUTRAL] OK, the date of service was [PII]. Total charges submitted were $3,795.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and I'm still waiting on my system. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] OK, thank you, ma'am, for your patience. Um, yes, we received this claim on
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And it processed on [PII].
[AGENT][NEUTRAL] The claim number is 3545088.
[AGENT][NEUTRAL] And the claim denied because under this policy for anesthesia visits or any outpatient um benefits related to surgeries, we cover up to $125 per day and that benefit maxed out on a previous claim.
[CUSTOMER][NEUTRAL] So, so it's patient responsibility.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you [PII] have a good day.
[AGENT][NEUTRAL] Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No thank you so much have a good day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye bye.