AccountId: 011433970860
ContactId: 46ee1208-2e8e-4af4-8440-5742b767cc47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 428640 ms
Total Talk Time (AGENT): 148431 ms
Total Talk Time (CUSTOMER): 139520 ms
Interruptions: 5
Overall Sentiment: AGENT=0, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/46ee1208-2e8e-4af4-8440-5742b767cc47_20250624T17:32_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] You want to check status on the claim?
[AGENT][NEUTRAL] Sure, I can assist you with claim status. May I have your name?
[CUSTOMER][NEUTRAL] My name is [PII] from Holy Cross Hospital.
[AGENT][NEUTRAL] OK, thank you. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh boy.
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 019785.
[CUSTOMER][NEUTRAL] 6 ML 7.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And sale [PII].
[AGENT][NEUTRAL] OK, that's not what I pulled. Can you repeat that number one more time?
[CUSTOMER][NEUTRAL] 0197856 ML 7.
[AGENT][NEUTRAL] It's missing one digit. Do you have the copy of the card?
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Hold on, that's the Medicare. Hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 318-052-321-11.
[AGENT][NEGATIVE] Um, no, it's gonna be almost like the one you gave me, but it's missing one digit, so it's a 0 followed by 7 digits. You're gonna miss it.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK. No, I don't, they didn't, they didn't, they didn't make no, they didn't make no, um.
[CUSTOMER][NEUTRAL] Copy of that card. I'm looking at it now I just got the Medicare card. Oh my goodness. Here we go.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] Um, OK, so let's just, um,
[AGENT][NEUTRAL] Let me have the spelling of the first and last name.
[CUSTOMER][NEUTRAL] [PII] Last name [PII]
[CUSTOMER][NEUTRAL] Birthday [PII].
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, I think I found her.
[AGENT][NEUTRAL] Let's see 168.
[AGENT][NEUTRAL] 126 [PII]. OK.
[AGENT][NEUTRAL] All right, I found her, so we just need to add an 8 after the 6 and um let's see, what is.
[CUSTOMER][NEUTRAL] Uh oh, wait a minute. So, the number, the number is 0, I mean 0197856.
[CUSTOMER][NEUTRAL] 8 ML.
[AGENT][NEUTRAL] 8.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I mean MML 7.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, so data services 4 1025, huh?
[AGENT][NEUTRAL] What, what
[AGENT][NEUTRAL] 41025. OK.
[AGENT][NEUTRAL] How much is the total charge?
[CUSTOMER][NEUTRAL] Through 4:30 2.
[CUSTOMER][NEUTRAL] Total charge, we have a $68,231.50.
[AGENT][NEUTRAL] OK, and that's a full range of days.
[CUSTOMER][NEUTRAL] OK, so this is, OK, this is a, OK, OK, wait, yeah, OK, um, they got it broken down. The um first data service that they have is 41025 for 34,000.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] 425.
[CUSTOMER][NEUTRAL] Wait,
[CUSTOMER][NEUTRAL] It's just great. OK, like they paid that one. They paid that 1425. They paid, uh, no, they didn't. I don't know what's going on. Oh yeah, they paid 27.
[AGENT][NEUTRAL] No, the policy was terminated.
[CUSTOMER][NEUTRAL] To, huh?
[AGENT][NEGATIVE] We did not pay. The policy was terminated terminated during that time of service.
[CUSTOMER][NEUTRAL] Oh, did I medicate.
[AGENT][NEUTRAL] We denied saying that the policy was terminated.
[CUSTOMER][NEUTRAL] OK, so you received this claim what day?
[AGENT][NEUTRAL] Uh, let me get that pulled up that 678.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] 3678 we received the claim on [PII]. We processed on [PII] and we denied the claim stating that the service was rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] When the term?
[AGENT][NEUTRAL] OK, the policy was effective from, let's see.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], OK, [PII] you said?
[AGENT][NEUTRAL] No, on the effective date.
[CUSTOMER][NEUTRAL] To [PII].
[AGENT][NEUTRAL] Mm mm, no. Effective date?
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Terminated [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK. So, give me a reference for the call.
[AGENT][NEUTRAL] OK, we don't have reference numbers. You can use my name in today's date. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Yeah, you didn't, what's your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII] [PII]. That's initial [PII].
[CUSTOMER][NEUTRAL] And and today's date?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. All righty then. Well, thank you so much. You have a good day, OK?
[AGENT][POSITIVE] You as well, and thank you for calling APL bye bye.
[CUSTOMER][NEUTRAL] Bye.