AccountId: 011433970860
ContactId: dd8c6c91-0bde-45c2-a7c1-1a0f015fc9b6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160860 ms
Total Talk Time (AGENT): 60319 ms
Total Talk Time (CUSTOMER): 51990 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/dd8c6c91-0bde-45c2-a7c1-1a0f015fc9b6_20250401T14:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi Ms. [PII], I need to check on 2 claims for a patient.
[AGENT][NEUTRAL] OK, I'm happy to check on some claims. Do we have their policy number?
[CUSTOMER][NEUTRAL] 02362054
[AGENT][POSITIVE] Alright, thank you so much let me pull this up here.
[AGENT][NEUTRAL] And can I grab your first name and a callback number?
[CUSTOMER][NEUTRAL] My name is [PII], and it's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Uh, Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you and data service?
[CUSTOMER][NEUTRAL] Um, the first one is, uh, oh, hold on, [PII] for 385.
[AGENT][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] So it looks like we did receive a claim, [PII] for the state of service. Claim was received [PII]. Claim was denied. Uh, looks like policy provides no benefits for charges made by a doctor for inpatient visits. It's a denial.
[CUSTOMER][NEUTRAL] No hospital coverage, right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright, let me verify and see if the hospital gave him a deal.
[CUSTOMER][POSITIVE] Alright thank you.
[AGENT][POSITIVE] Yeah, no problem. Anything else?
[CUSTOMER][NEUTRAL] Um, I guess it's gonna be the same thing for [PII] and [PII] as well. You do have it right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 616.
[CUSTOMER][NEUTRAL] It's one claim, um, $453.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, it looks like it's the same denial code, yeah.
[CUSTOMER][NEUTRAL] All right, and no, no write off, no adjustment at all, right? Full patient balance?
[AGENT][NEGATIVE] Yeah, it looks like, yeah, they were all denied.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][MIXED] Oh I hate that. All right, thank you.
[AGENT][POSITIVE] You're welcome have a nice day, [PII].
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] OK.