AccountId: 011433970860
ContactId: 210ee0a6-b92a-4a57-8b2d-fdce6bc49620
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 150630 ms
Total Talk Time (AGENT): 41779 ms
Total Talk Time (CUSTOMER): 86940 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/210ee0a6-b92a-4a57-8b2d-fdce6bc49620_20250606T20:07_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], it's [PII] calling from Homestead Hospital. I need you to verify coverage. Uh, we, we sent a claim and it came back. You guys couldn't ID and I looked in the file and found a different policy number. So before I rebuild it, I wanna make sure.
[AGENT][NEUTRAL] OK, I can help you with that, [PII]. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and what's the policy number that you have?
[CUSTOMER][NEUTRAL] Uh, the card I'm looking at says 01, well, it says inpatient, no, inpatient benefit certification number outpatient. This is an outpatient claim, right, OK, all good. 01666110 ML 8.
[AGENT][NEUTRAL] Either one works.
[AGENT][NEUTRAL] And what's that patient name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII], uh, date of birth [PII].
[AGENT][NEUTRAL] Uh, yes, got this policy active and effective [PII].
[CUSTOMER][NEUTRAL] To current wow, they've had it a long time I guess we, we build with, is there any way if if you guys are rejecting a claim or denying a claim that you could have it processed with the correct number since you have the EOB in the bill already or no? I need to rebuild.
[AGENT][NEUTRAL] Um, well, we, we would look for them, uh, if we had the identifying information, we would process this is the only policy they have, so I don't, I don't see another policy. Do you, I can check and see if we have the claim by chance. Do you have the date of service and bill charges?
[CUSTOMER][NEUTRAL] The the
[CUSTOMER][NEUTRAL] Sure, it's [PII] this year.
[CUSTOMER][NEUTRAL] Charges are 21,889 because we received a letter, um, let's see what the letter says again.
[CUSTOMER][NEUTRAL] That you couldn't identify the patient.
[CUSTOMER][NEUTRAL] The enclosed information was submitted to APL.
[CUSTOMER][NEGATIVE] However, we're unable to locate the correct policy.
[AGENT][NEUTRAL] May have been her last name.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] It may have been her last name that there was something that threw us off, but yeah, I don't have that claim on file, so yes, if you can resubmit.
[CUSTOMER][NEUTRAL] Will do. What's your name again?
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][POSITIVE] [PII], thank you so much. Have a great weekend.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye-bye.