AccountId: 011433970860
ContactId: 8196f2a4-654a-416b-acbd-448d7292880e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 293480 ms
Total Talk Time (AGENT): 54242 ms
Total Talk Time (CUSTOMER): 81611 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/8196f2a4-654a-416b-acbd-448d7292880e_20250415T17:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. My name is [PII] and I'm just calling here with Memorial Health Care Patient Financial Services.
[CUSTOMER][NEUTRAL] I am calling to verify on a couple claims that we had previously been billed out that denied member called in and request that we followed up as insurance is saying that he had coverage and what we had on file is that he had no coverage for the time of visit.
[AGENT][NEUTRAL] Hi.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, we can be reached at [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, that would be [PII]. Policy number is 02.
[CUSTOMER][NEUTRAL] 23
[CUSTOMER][NEUTRAL] 0090.
[AGENT][NEUTRAL] And what was that, uh, her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what was that date of service?
[CUSTOMER][NEUTRAL] There are a few of them. First one is [PII].
[AGENT][NEUTRAL] And the bill charges?
[CUSTOMER][NEUTRAL] 3260.
[AGENT][NEUTRAL] OK, let's see
[AGENT][NEUTRAL] And that was for Memorial Medical, is that right?
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] With
[AGENT][NEUTRAL] OK, looks like, let's see.
[AGENT][NEUTRAL] Was that for an office visit?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So office visits are not covered under the policy?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you check it?
[CUSTOMER][NEUTRAL] 4 more dates. I just wanna be sure that they were all processed correctly.
[AGENT][NEUTRAL] Yes, same patient.
[CUSTOMER][NEUTRAL] Yes, so I have [PII].
[AGENT][NEUTRAL] Let me pull that up
[AGENT][NEUTRAL] OK looks like the same denial.
[CUSTOMER][NEUTRAL] OK, and then [PII].
[AGENT][NEUTRAL] And let's see that one.
[AGENT][NEUTRAL] Uh, same thing on that. Let me see if this, let me look up this code though.
[AGENT][NEUTRAL] OK, yeah, same thing, denial on the office visit.
[CUSTOMER][NEUTRAL] And then [PII].
[AGENT][NEUTRAL] Uh, same thing on that.
[CUSTOMER][NEUTRAL] And last 1 [PII].
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEGATIVE] Yeah, same thing on that, yeah, there's no uh benefit for office visits specifically.
[CUSTOMER][POSITIVE] OK, well thank you so much. I appreciate that information. I'll be sure we make the correction.
[AGENT][POSITIVE] OK, thanks for calling APL. I hope you too bye.
[CUSTOMER][POSITIVE] You have a great day.
[CUSTOMER][NEUTRAL] Um bye bye.