AccountId: 011433970860
ContactId: 55e3a8f6-1813-4875-9cdc-24918869fb26
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 394119 ms
Total Talk Time (AGENT): 72801 ms
Total Talk Time (CUSTOMER): 104807 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/55e3a8f6-1813-4875-9cdc-24918869fb26_20250613T19:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] calling from provider's office to checking on claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] So it's [PII] and it's a direct line.
[AGENT][NEUTRAL] OK. And do you have a policy number for the patient?
[CUSTOMER][NEUTRAL] You, the policy ID is gonna be.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 02584614
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient name was uh [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Date of birth is [PII] for, for the charge amount 1932 even.
[AGENT][NEUTRAL] Uh, it looks like the claim was received on 4-28-25.
[AGENT][NEUTRAL] Process [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, benefit maximum for the date of service has been met dollar amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Where is the patient have met uh dollar amount or the discount?
[AGENT][NEUTRAL] The the benefit payable, the dollar amount for the benefit payable was met on another claim.
[CUSTOMER][NEUTRAL] Dollar values but.
[CUSTOMER][NEUTRAL] What is the dollar value?
[AGENT][NEUTRAL] At 75.
[CUSTOMER][NEUTRAL] $75 even?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Could you please help me with that uh date of service which the claim got already paid?
[AGENT][NEUTRAL] The same date of service.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. I I paid for, uh, uh, you know.
[CUSTOMER][NEUTRAL] Hospital claim?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, can I get the claim number?
[AGENT][NEUTRAL] 359
[AGENT][NEUTRAL] 5964.
[CUSTOMER][NEUTRAL] OK. Could you please send me the denied claim number?
[AGENT][NEUTRAL] That that's the claim number.
[CUSTOMER][NEUTRAL] OK. Could you please help me the claim number which the claim got paid?
[AGENT][NEUTRAL] I, I can only give you claim information specifically for claims that you're you're with that provider. Are you with that provider, the provider?
[CUSTOMER][NEUTRAL] Yes. Yeah. The provider is Anderson M Austin Emergency Center.
[AGENT][NEUTRAL] 359-589-4.
[CUSTOMER][NEUTRAL] 349 5
[CUSTOMER][NEUTRAL] 5984. Correct.
[AGENT][NEUTRAL] 5894.
[CUSTOMER][NEUTRAL] OK, I'm sorry. Could you please repeat that again?
[AGENT][NEUTRAL] 359-589-4.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[CUSTOMER][NEUTRAL] OK. Is there any letter has been sent to the patient, [PII]?
[AGENT][NEUTRAL] Yes, we send an EOB to the patient, yes.
[CUSTOMER][NEUTRAL] Oh, when was that?
[AGENT][NEUTRAL] Or [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And this bill amount of $1,932 which is patient responsibility, correct?
[AGENT][NEUTRAL] We can't determine patient responsibility as a supplemental policy.
[CUSTOMER][NEUTRAL] OK. Does the patient have any other coverage?
[AGENT][NEUTRAL] Um, I don't show any on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much. Call reference please.
[AGENT][NEUTRAL] That's my name, [PII], first initial to last name [PII], and today's date.
[CUSTOMER][POSITIVE] OK, [PII]. Thank you. Thank you so much for the assistance. You have a lovely day. Bye.
[AGENT][POSITIVE] Thanks for calling APL you as well. Bye bye.