AccountId: 011433970860
ContactId: 729c713b-af1a-4d04-bb61-928e629f7bf1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 307980 ms
Total Talk Time (AGENT): 83310 ms
Total Talk Time (CUSTOMER): 69209 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/729c713b-af1a-4d04-bb61-928e629f7bf1_20250227T18:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is. How may I help you?
[CUSTOMER][NEUTRAL] Yes, this is [PII] from Moore County Hospital District, and I'm just needing to check on a claim.
[AGENT][NEUTRAL] OK, I can help you with the claim. And what was the name of the hospital you're calling from again, Ms. [PII]?
[CUSTOMER][NEUTRAL] Moore County Hospital.
[AGENT][NEUTRAL] Moore County, OK.
[AGENT][POSITIVE] Thank you and then may I also get your call back number just in case our call is disconnected.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And then can you please give me the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, it's [PII], um, [PII], and the policy is 02449073.
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[AGENT][NEUTRAL] OK, and then what is the date of service?
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] $3,576.91.
[AGENT][NEUTRAL] Thank you and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Um, $1,243.53.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold Ms. [PII], while I pull this claim up for us and I'll be right back.
[CUSTOMER][POSITIVE] All right thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you Ms. [PII] for holding for me. So I did find the claim. The claim number is 3483957.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim was denied because the patient had maxed out their outpatient benefit for the calendar year.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] And what was that claim number? What was the number before 8?
[AGENT][NEUTRAL] 348.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so are y'all leaving that to the patient?
[AGENT][NEGATIVE] We don't give patient responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what was your name?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] OK, and do you have a reference number for this call?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name and today's date.
[CUSTOMER][NEUTRAL] OK, and I think she has one more that I was gonna ask about.
[CUSTOMER][NEUTRAL] Let me see.
[AGENT][NEUTRAL] OK, well
[CUSTOMER][NEUTRAL] Yes, and this one would have been later so.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then what is the charge amount?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh hold on.
[CUSTOMER][NEUTRAL] Um, never mind, I guess it's.
[CUSTOMER][NEUTRAL] Not with you, OK.
[AGENT][POSITIVE] OK. All right. Well, thank you so much, Ms. [PII]. You have a great day and thanks for calling APL.
[CUSTOMER][POSITIVE] Alright thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All right you too thank you.
[AGENT][NEUTRAL] Bye bye