AccountId: 011433970860
ContactId: 0d44c1e0-72ee-4237-8668-a8a7117fbdae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 317170 ms
Total Talk Time (AGENT): 116815 ms
Total Talk Time (CUSTOMER): 123223 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/0d44c1e0-72ee-4237-8668-a8a7117fbdae_20250501T20:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, [PII]. It's uh [PII] calling from Houston Methodist Hospital. I reference the claim status.
[AGENT][NEUTRAL] OK Miss [PII], I can help you with claim status. um can I please get your callback number, ma'am just in case the call gets disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[AGENT][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Uh, yes, and showing that um and what order? I'm sorry, I heard you, but I, what order did you need it again?
[AGENT][NEUTRAL] No, that's OK.
[AGENT][NEUTRAL] And um the date of birth is next and then the policy number.
[CUSTOMER][NEUTRAL] OK, date of birth is [PII]. Policy number 02495043.
[AGENT][NEUTRAL] OK, let me look her up real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome, and that was 02495043?
[CUSTOMER][NEUTRAL] Uh, sounds right. Let me just repeat it. Uh, 02495043.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said it was for an [PII]?
[CUSTOMER][NEUTRAL] Uh, you have [PII]. I have [PII].
[AGENT][NEUTRAL] [PII], yes, OK. All right, I've got it pulled up.
[AGENT][NEUTRAL] OK, and what is the data service of the claim?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yes, that data service I'm showing it to be data service of uh [PII] and the amount of.
[CUSTOMER][NEUTRAL] 1,944,950.
[AGENT][NEUTRAL] OK, and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Oh, that would be an issue because we're billing you as primary.
[AGENT][NEUTRAL] Huh, we're second
[AGENT][NEUTRAL] And dairy.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK. Secondary.
[CUSTOMER][NEUTRAL] Let's see if we have any other insurance. Hold on one moment.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Cause I know books possibly a student, so let me see what information I do have.
[AGENT][NEUTRAL] And I'll look while you're doing that I'm gonna look and see if we have the claim.
[AGENT][NEUTRAL] On file yet.
[CUSTOMER][NEUTRAL] Because I do see
[CUSTOMER][NEUTRAL] Yeah, because it looks like we may have gotten a denial, but it's unclear what that denial is.
[AGENT][NEUTRAL] Oh, I see.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] On that denial, what is the claim? Are you seeing the claim number? Oh wait, I see it right here. I found it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 3571365 is the claim number.
[AGENT][NEUTRAL] Now let me look and see what the remark is.
[CUSTOMER][NEUTRAL] Yeah, that's what I don't have is a remark code on here. I see the remark code but I don't have that descriptive page, so.
[AGENT][NEUTRAL] OK, it says that these services were rendered after coverage was terminated.
[AGENT][NEUTRAL] Let me see if they have.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] The policy on file and it might be under that one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] This policy terminated on [PII].
[AGENT][NEUTRAL] And don't have any other active policy.
[CUSTOMER][NEUTRAL] January
[CUSTOMER][NEUTRAL] [PII]. OK, so [PII].
[CUSTOMER][NEUTRAL] [PII], basically.
[CUSTOMER][NEUTRAL] Or did you say [PII], OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date, it started on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Great, thank you so much.
[AGENT][POSITIVE] Very well
[AGENT][NEUTRAL] Miss [PII], is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] No, ma'am, not this time, but thank you so much. You have such a lovely day.
[AGENT][POSITIVE] You too thank you for calling APL you have a good night.
[CUSTOMER][POSITIVE] You as well thank you bye bye.
[AGENT][NEUTRAL] Bye-bye.