AccountId: 011433970860
ContactId: e843f241-1c31-4d8a-8b9f-93af3307b416
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 586969 ms
Total Talk Time (AGENT): 94270 ms
Total Talk Time (CUSTOMER): 139117 ms
Interruptions: 7
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/e843f241-1c31-4d8a-8b9f-93af3307b416_20250123T15:21_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, uh, my name is [PII]. I'm calling in to check on our claims.
[AGENT][NEUTRAL] OK, I can help you with claim status. Can you please spell your first name for me?
[CUSTOMER][NEUTRAL] Yeah, [PII]
[AGENT][NEUTRAL] OK [PII], what is your call back number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Ok and what is your call?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you sir and then what is the patient's name?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] OK and was [PII]'s date of birth?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Thank you, and then the policy number, please.
[CUSTOMER][NEUTRAL] and the policy number.
[CUSTOMER][NEUTRAL] 020980999.
[AGENT][NEUTRAL] OK, let me pull in that policy.
[AGENT][NEUTRAL] OK and then what is the date of service?
[CUSTOMER][NEUTRAL] OK, and what's the date of service?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] Uh, $7,156 770.
[AGENT][NEUTRAL] OK and then what is the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] And what is the name of the?
[CUSTOMER][NEUTRAL] Perry's Regional Medical Center.
[CUSTOMER][NEUTRAL] P A R I S P Paris.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold.
[CUSTOMER][POSITIVE] Mhm. Sure, take your time, please.
[AGENT][NEUTRAL] Thank you. I'm gonna put you on a brief hold. I'm gonna look up this claim for you and I'll be right back. Thank you, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Wow
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hey [PII], this is [PII] back with you again. I found the claim and the claim number is 321-355-4.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Number is
[CUSTOMER][NEUTRAL] 3554.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was denied because outpatient hospital or physician office.
[CUSTOMER][NEUTRAL] I was not because I'll take it.
[AGENT][NEUTRAL] Um, the outpatient rider only allows payment for outpatient surgery in an outpatient hospital or a physician's office. There for benefits are payable.
[CUSTOMER][NEUTRAL] This.
[CUSTOMER][NEUTRAL] It just matter only last payment.
[CUSTOMER][NEUTRAL] A surgery in a hospital or just office their benefits are payable.
[CUSTOMER][NEUTRAL] Outpatient visits. OK. So it's.
[AGENT][NEUTRAL] So it
[AGENT][NEUTRAL] It's a non covered facility.
[CUSTOMER][NEUTRAL] It's a covered facility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, is it possible that you could, uh, fax the EOB?
[AGENT][NEUTRAL] Yes sir, what's your fax?
[CUSTOMER][NEUTRAL] Sir, what's your
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] 462.
[CUSTOMER][NEUTRAL] 4454.
[AGENT][NEUTRAL] OK, I'm gonna put you on hold while I get that faxed over to you. I'll be right back.
[CUSTOMER][NEGATIVE] You don't like that
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK [PII] that fax is on its way to you.
[CUSTOMER][POSITIVE] All right. Thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Uh, is there a reference number that I can get?
[AGENT][NEUTRAL] Yes, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] My name's [PII] and today's day. OK.
[CUSTOMER][POSITIVE] All right then thank you so much uh that will be all.
[AGENT][POSITIVE] Thank you, [PII]. You have a good day and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you you have a good day and thanks for calling ATO. You as well take care.
[AGENT][POSITIVE] Thank you, sir. Bye-bye.