AccountId: 011433970860
ContactId: dd7c1d6a-25e1-4001-9e59-5a79c450dd3f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184720 ms
Total Talk Time (AGENT): 70904 ms
Total Talk Time (CUSTOMER): 87715 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/dd7c1d6a-25e1-4001-9e59-5a79c450dd3f_20250417T16:24_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling from Scripps Health, Scripps Hospital. I'm not sure if I'm calling the right department. I'm calling in regards to a claim, please.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I can help you with that, [PII]. Can I get a callback number for you?
[CUSTOMER][NEUTRAL] Direct line [PII].
[AGENT][NEUTRAL] Thank you. And what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] D for David, 46401571.
[AGENT][NEUTRAL] OK, that is not one of our policy numbers. Let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have a social for the patient?
[CUSTOMER][NEUTRAL] Um, let me see if I have.
[CUSTOMER][NEUTRAL] Uh-huh
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] One moment, please.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] How about [PII]?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Last name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you so much for verifying uh the policy and you did say you were calling for status today. What is the data service?
[CUSTOMER][NEUTRAL] [PII], 2025 and the bill amount is $4,607.60.
[CUSTOMER][NEUTRAL] Does the member have um
[AGENT][NEUTRAL] What is the
[CUSTOMER][NEUTRAL] ER services benefit, I'm sorry, go ahead.
[AGENT][NEUTRAL] Could I get the total bill again? I'm sorry.
[CUSTOMER][NEUTRAL] No problem. $4,607.60.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] OK, so this claim was denied. Uh, it does show that this policy does not cover emergency room facility visit.
[AGENT][NEUTRAL] Our outpatient.
[CUSTOMER][NEUTRAL] OK, no ER coverage.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Can I have call reference number, please?
[AGENT][NEUTRAL] Is there anything else I can help you with?
[AGENT][NEUTRAL] Yes, to reference our call.
[CUSTOMER][NEUTRAL] Call reference number please.
[AGENT][NEUTRAL] You'll use my name, [PII] and today's date.
[CUSTOMER][POSITIVE] Today's date. OK. Thank you, [PII]. Appreciate your help.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] You're welcome. You have a wonderful day. Thank you for calling APL. Bye bye.
[CUSTOMER][POSITIVE] Have a good day. You too.
[CUSTOMER][NEUTRAL] Bye-bye.