AccountId: 011433970860
ContactId: e6ce5748-a851-487d-9186-cf0e5f16ee4c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 566739 ms
Total Talk Time (AGENT): 124725 ms
Total Talk Time (CUSTOMER): 47304 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=-1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/e6ce5748-a851-487d-9186-cf0e5f16ee4c_20250613T16:02_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey, so I'm calling to check claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status. May I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], and Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] And um may I have the name of the facility you're calling from Miss [PII]?
[CUSTOMER][NEUTRAL] South Georgia Medical Center.
[AGENT][NEUTRAL] July
[AGENT][NEUTRAL] OK. Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02566205
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you and may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] the bill amount is $638.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Can you um repeat that date of service I wrote it down but I got too many numbers.
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. All right. Let me see if I can find this claim for you and for future, you can check claim status online through our website at [PII] and that's just optional. And let me see if this is your claim. One moment, let me pull this ERP.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The meeting on the system.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so here it is.
[AGENT][NEUTRAL] OK, looks like we processed the claim on [PII] and the claim was denied. Um, let me get the denial reason.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] OK, the reason is the calendar year maximum benefit for routine health screening has been met for the calendar year. So the benefits have exhausted.
[CUSTOMER][NEUTRAL] OK, what's the claim number for this one?
[AGENT][NEUTRAL] Claim number is 3561119.
[CUSTOMER][NEUTRAL] OK, can I have an EOB emailed to me?
[AGENT][NEUTRAL] Mm, I can fax it. You don't have fax number?
[CUSTOMER][NEUTRAL] Mhm 229259-4949.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK. [PII] to your attention.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK. Do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Ms. [PII]. OK, I went ahead and send that over to you. Should be there in a few minutes. Is there anything else I'm gonna help you with today?
[CUSTOMER][POSITIVE] And I love, I just need a reference number.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK, that's [PII].
[CUSTOMER][POSITIVE] OK thank you have a good one.
[AGENT][POSITIVE] You too and thank you for calling APL. Have a good weekend.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] No