AccountId: 011433970860
ContactId: 355e9e11-03f7-40da-968d-b833c37373b5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 247389 ms
Total Talk Time (AGENT): 93038 ms
Total Talk Time (CUSTOMER): 75983 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/355e9e11-03f7-40da-968d-b833c37373b5_20250424T15:19_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm on this side calling from private office.
[AGENT][NEUTRAL] Can you repeat your name or spell out your name?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] It is Northeastern Health System.
[CUSTOMER][NEUTRAL] Sequoya.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Sequoia.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, policy number is 01931396.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes. Patient's name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And how much is the total charge?
[CUSTOMER][NEUTRAL] Actually, I do have the claim number as well.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] $324.
[AGENT][NEUTRAL] 324. What's the claim number that you have?
[CUSTOMER][NEUTRAL] And the claim number is
[CUSTOMER][NEUTRAL] 358-826-4.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so this one was denied stating that the service was rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] Yes. So, can I know the termination date for this, for the coverage for this?
[AGENT][NEUTRAL] Yes, this policy, uh, did not was not activated after the
[AGENT][NEUTRAL] Let's see, so this one never became active. It was created and terminated the same date, so it was [PII], terminated [PII].
[AGENT][NEUTRAL] And I do see another policy. Oh, go ahead.
[CUSTOMER][NEUTRAL] OK. It was [PII].
[CUSTOMER][NEUTRAL] The date was [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And I do have another one policy number as well. Can you check with this one? There is any policy active with this mem for this number?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] It is 1359317.
[AGENT][NEUTRAL] OK, yeah, that's the other one I was gonna tell you. I do see that one, but it's also terminated on [PII].
[CUSTOMER][NEUTRAL] OK. So this, this policy is also term on [PII], right?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] And first one is [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, can you provide me the whole reference number for this?
[AGENT][NEUTRAL] We don't have a reference numbers so you can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] How do you spell your name?
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] No, it's enough for today.
[AGENT][POSITIVE] OK, thank you for calling APO. Have a good afternoon.