AccountId: 011433970860
ContactId: 2d35e99a-081a-4962-966d-1cad1e902274
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 407070 ms
Total Talk Time (AGENT): 133010 ms
Total Talk Time (CUSTOMER): 92206 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/2d35e99a-081a-4962-966d-1cad1e902274_20250604T21:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] How you doing [PII]?
[AGENT][POSITIVE] Hi, how are you today?
[CUSTOMER][POSITIVE] I'm doing great. My name is [PII]. I'm calling from Memorial Herman Hospital, and I'm calling to check status on the claim.
[AGENT][NEUTRAL] Sure, I can help you with claim status, [PII]. Can I get a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Right, and what is the policy number?
[CUSTOMER][NEUTRAL] Policy number is 02604421.
[AGENT][NEUTRAL] Give me just a moment while I look that up.
[CUSTOMER][POSITIVE] No problem. How's your day going?
[AGENT][POSITIVE] Good, how was yours?
[CUSTOMER][POSITIVE] It's great, can't complain, so I'm also.
[AGENT][NEUTRAL] Yes, it is almost over.
[AGENT][NEUTRAL] Can I get you to verify the uh patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] Yes, um, [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you so much. And do you have the uh claim number or date of service?
[CUSTOMER][NEUTRAL] Yeah, the data service is gonna be April 28, 2025 for a total charge of $14,832.75.
[AGENT][NEUTRAL] Alright, give me just a moment while I look that up.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] And are you spelling your name [PII]?
[AGENT][NEUTRAL] Yes, [PII] and last initial is [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I apologize, what hospital are you calling from again?
[CUSTOMER][NEUTRAL] Memorial Herman Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like we received this claim on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 359-9219.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Oh hold on.
[AGENT][NEUTRAL] I think I got my lines mixed up, give me just a moment.
[CUSTOMER][POSITIVE] No problem. No, you good.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEGATIVE] Oh sorry.
[CUSTOMER][POSITIVE] Yeah, oh, you good.
[AGENT][NEGATIVE] I was on the wrong line. Uh, it was actually received on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Claim number is 3599215.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it looks like we paid partial to this.
[AGENT][NEUTRAL] Uh, it looks like we paid $350.
[AGENT][NEUTRAL] And it looks like with that check, the maximum benefit payable for that data service has been met.
[CUSTOMER][NEUTRAL] OK, so the balance will be the patient responsibility?
[AGENT][NEUTRAL] Uh, we don't determine patient responsibility that would be up to the provider or their uh.
[AGENT][NEUTRAL] Primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1 2nd.
[CUSTOMER][NEUTRAL] OK, so according to you all, is there any patient responsibility?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Um, no, not for us.
[CUSTOMER][NEUTRAL] OK, is this a limited liability policy or?
[AGENT][NEUTRAL] This is a hospital indemnity policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, you have the check number?
[AGENT][NEUTRAL] OK, the check number is 20.
[AGENT][NEUTRAL] 43422.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that was sent out on what date?
[AGENT][NEUTRAL] Let me check for you.
[AGENT][NEUTRAL] It looks like it was sent in one check.
[AGENT][NEUTRAL] Uh, we sent it on [PII] and it looks like the check cleared on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, [PII].
[CUSTOMER][POSITIVE] OK. All right. Well, thank you very much.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Um, I'm trying to make sure I got everything. Now, is there a call reference number?
[AGENT][NEUTRAL] So we don't have call reference numbers but you can use my name and last initial in today's date.
[CUSTOMER][POSITIVE] OK. All right, well, thank you very much. You have a wonderful day and enjoy the rest of your week, OK?
[AGENT][POSITIVE] Great, thank
[AGENT][POSITIVE] Alright you too thank you for calling APL.
[CUSTOMER][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] Bye bye.