AccountId: 011433970860
ContactId: e13561b9-ae78-4508-91c5-2b1c0b78dd66
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 162050 ms
Total Talk Time (AGENT): 66944 ms
Total Talk Time (CUSTOMER): 69858 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/2025/02/04/e13561b9-ae78-4508-91c5-2b1c0b78dd66_20250204T15:12_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling on behalf of a provider's office. I have a claim that I have a denial on, and I was just trying to figure out uh what is the, the reason that it wasn't covered.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII], sure, I can assist you with claims. May I have the name of where you're calling from?
[CUSTOMER][NEUTRAL] Yes, I'm calling from let me see this provider is pretty sure it's Shawni.
[CUSTOMER][NEUTRAL] SSM Medical Group in [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, I have.
[CUSTOMER][NEUTRAL] 01792085
[AGENT][NEUTRAL] All right. And what is the name and date of birth of the patient?
[CUSTOMER][NEGATIVE] OK. So, so I'm probably gonna mess this up, OK? Because it is a, it's a doozy here. OK. I think it's [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, that's good in it.
[CUSTOMER][NEUTRAL] She goes by [PII].
[AGENT][POSITIVE] Oh, that's good.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right. And what's your date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Mm thank you.
[AGENT][NEUTRAL] All right. And do you have a claim number or you have the date of service for the claim?
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Uh, the data service is $7224. Um, the total bill amount was $247.
[AGENT][NEUTRAL] OK. All right, let me check on that.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so it was nice stating that office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] I'm sorry, give me one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, my headset went out a little bit. What was the denial?
[AGENT][NEUTRAL] Office visits are not covered by this policy.
[CUSTOMER][NEUTRAL] By her policy, OK, got you, and what's the first initial of your last name?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and can I have a reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you like an extension.
[CUSTOMER][POSITIVE] So, OK, I got you. OK, thank you so much. That's all I needed. That was the only claim that I had. Thank you so much. Have a good day.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] All right, you too, and thank you for calling ATL. Have a great day.
[CUSTOMER][NEUTRAL] Bye bye.