AccountId: 011433970860
ContactId: 40cd7a4f-b994-4ac4-820b-cdc6494e33ca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 347209 ms
Total Talk Time (AGENT): 105322 ms
Total Talk Time (CUSTOMER): 111244 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/40cd7a4f-b994-4ac4-820b-cdc6494e33ca_20250327T15:44_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Thank you for calling ETL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling for hospital claims to check on a client denial verifications. How are you doing today?
[AGENT][POSITIVE] I'm good. Thank you for asking. How are you?
[CUSTOMER][POSITIVE] Yes, I am doing great. Thank you so much for asking.
[AGENT][POSITIVE] I'm Happy to check on a claim for you today. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] And before that, may I know the insurance name, please?
[AGENT][NEUTRAL] Uh, this is American Public Life Insurance.
[CUSTOMER][POSITIVE] Thank you so much, [PII], for your information.
[CUSTOMER][NEUTRAL] The member ID is 02479149.
[AGENT][POSITIVE] All right, thank you so much. Let me pull this up and do you have a good call back number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. Callback number is [PII] and it is a direct line, no extension.
[AGENT][NEUTRAL] Thank you for that. And patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you and then data service.
[CUSTOMER][NEUTRAL] Let me check. The service is uh 103 of it is [PII].
[CUSTOMER][NEUTRAL] And the total charges is $462 even.
[AGENT][NEUTRAL] The date of service is [PII].
[CUSTOMER][POSITIVE] Yes, you're correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the amount.
[AGENT][NEUTRAL] I apologize. And what was the bill amount again?
[CUSTOMER][NEUTRAL] It is $462 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Alright, so it looks like we did receive a claim for the state of service claim is received [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Uh, the claim was denied. It looks like the services were rendered after.
[AGENT][NEGATIVE] Term coverage was terminated.
[CUSTOMER][NEUTRAL] All, all right.
[CUSTOMER][NEUTRAL] May I know the rental service rent the date?
[AGENT][NEUTRAL] The effective date was [PII].
[AGENT][NEUTRAL] The policy terminated on [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Oh, all right.
[CUSTOMER][NEUTRAL] So for this service, uh, is there any active insurance for this state of service for this patient?
[AGENT][NEUTRAL] I don't see any other active plans with us.
[CUSTOMER][NEUTRAL] All right. So for the processing this claim, what should we do for this?
[AGENT][NEUTRAL] Well, the member doesn't have any active, uh, insurance with us, so it's up to the facility or provider if they wanna bill the patient.
[CUSTOMER][POSITIVE] All right. Thank you so much.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, may I know the claim process date?
[AGENT][NEUTRAL] Uh, yeah, one moment.
[AGENT][NEUTRAL] Claim is processed on [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] All right. Thank you. May I know the claim number?
[AGENT][NEUTRAL] Claim number is 352-9099.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, can I, for this claim, can you bill the patient?
[AGENT][NEUTRAL] We're not able to advise on that. That's up to the facility or provider.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] All right, thank you so much for the information. Um, could you please
[CUSTOMER][NEUTRAL] Provide the call reference number.
[AGENT][NEUTRAL] Call reference is my name with my last initials and today's date. My name again is [PII], that's [PII] Last initial is [PII].
[CUSTOMER][POSITIVE] Thank you so much sir for your assistance. Have a great day. Bye for now. Stay safe.
[AGENT][NEUTRAL] You too. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.