AccountId: 011433970860
ContactId: fbec7de9-6869-4252-89d7-ad40168a6434
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 338940 ms
Total Talk Time (AGENT): 85965 ms
Total Talk Time (CUSTOMER): 72127 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/fbec7de9-6869-4252-89d7-ad40168a6434_20250305T19:40_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Chilton Medical Center. I'm looking to get the status of a claim today.
[AGENT][NEUTRAL] OK, did you say your name is [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII], first [PII] of my last [PII] [PII].
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Thank you, [PII]. And your checking claim status. What's the, um, policy number?
[CUSTOMER][NEUTRAL] 02281581
[AGENT][NEUTRAL] OK, what's a good phone number, [PII], in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] and that's a direct line.
[AGENT][NEUTRAL] OK, thank you. Verify the uh patient's name and date of birth.
[CUSTOMER][NEUTRAL] Looks like it's [PII] [PII].
[AGENT][NEUTRAL] And you stated that they're that you are checking claim status. What, what is the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is that [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the total bill?
[CUSTOMER][NEUTRAL] $18,661.01.
[AGENT][NEUTRAL] OK, and would this be the facility charge?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Still looking.
[AGENT][NEGATIVE] Now I'm not showing that the claim has been received.
[AGENT][NEUTRAL] And it looks like she, she
[CUSTOMER][POSITIVE] OK, no worries. It looks like I, I think, go ahead, I'm sorry.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, I was gonna say it looks like she has two different policies that that claim can be considered under the one that you gave me.
[AGENT][NEUTRAL] And then the other policy number which is the Metlinkga policy.
[AGENT][NEUTRAL] The policy number is 2284615.
[AGENT][NEUTRAL] What type of uh service you do OK.
[CUSTOMER][NEUTRAL] Yeah, I have that one. It um.
[CUSTOMER][NEUTRAL] It looks like we have a 0 you'll be uploaded um.
[CUSTOMER][NEUTRAL] Saying that
[CUSTOMER][NEUTRAL] Treatment does not include outpatient surgeries, so that makes sense.
[AGENT][NEUTRAL] Under which policy number?
[CUSTOMER][NEUTRAL] The second one that you had said 022815181581.
[AGENT][NEUTRAL] Yeah, that's the one that you gave me, so let me go back to that one.
[AGENT][NEUTRAL] Is there a claim number number on the document that you have?
[CUSTOMER][NEUTRAL] 355-3679.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] How long were they in the hospital?
[CUSTOMER][NEUTRAL] Looks like it was outpatient surgery.
[AGENT][NEUTRAL] Oh, it was outpatient. OK, so that that denial is correct, OK.
[CUSTOMER][NEUTRAL] So makes sense.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, and do you know whether or not it was submitted under the 228-4615?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] I don't see it under that claim, I mean, that policy number.
[AGENT][NEUTRAL] Let me double check again.
[CUSTOMER][NEUTRAL] No, I think it was just submitted.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Under that first one, but you know what, no worries, um.
[CUSTOMER][NEUTRAL] I will go ahead and send this for review on my end thank you.
[AGENT][POSITIVE] OK. All [PII], [PII], any other questions I can help out with today?
[CUSTOMER][POSITIVE] That's all thank you.
[AGENT][POSITIVE] Uh, you're welcome. Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too.