AccountId: 011433970860
ContactId: 9ae5a427-df47-4474-a8d0-7b4b45220852
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 350119 ms
Total Talk Time (AGENT): 110486 ms
Total Talk Time (CUSTOMER): 116805 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/9ae5a427-df47-4474-a8d0-7b4b45220852_20250521T14:38_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling [PII] speaking. May I help you?
[CUSTOMER][NEUTRAL] Can you please spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Sorry, [PII]?
[AGENT][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] And how do you pronounce your name?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII] and your initial for the last name [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Hi, this is [PII] calling from provider's office to check for the claim status and my initial to the last name is [PII].
[AGENT][NEUTRAL] OK, I can verify claim status for you and I apologize, your name is again?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK. And [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] 02553130
[AGENT][NEUTRAL] Thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] OK. Thank you. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth was.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] It's for [PII] and the total bill amount was 42,952 dollars.76 cents.
[AGENT][NEUTRAL] And the balance after primary?
[CUSTOMER][NEUTRAL] Yeah, it's uh primary only.
[AGENT][NEUTRAL] No, I'm asking what is the balance after primary?
[CUSTOMER][NEUTRAL] It's also 42,952 dollars.76 cents.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Uh, show the claim process is service rendered after the policy terminated.
[AGENT][NEUTRAL] Policy termed on [PII].
[CUSTOMER][NEUTRAL] So there is no other active policy for the date of service?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Can you please double check is there any other active policy for the patient on this date of service?
[AGENT][NEGATIVE] No, they don't have any uh policies with our company.
[CUSTOMER][NEUTRAL] So what's the claim.
[CUSTOMER][NEUTRAL] Reserved date
[AGENT][NEUTRAL] Uh, claim received [PII], processed on [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] So is done [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and the claim was denied for active coverage, right?
[AGENT][NEUTRAL] The claim was denied as service rendered after policy terminated.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Because the service term rendered is terminated.
[AGENT][NEGATIVE] Service rendered after the policy terminated.
[CUSTOMER][NEUTRAL] After the policy terminated, right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And so there is no other active policy for the date of service, right?
[AGENT][NEUTRAL] No, the patient doesn't have any other coverage with our
[AGENT][NEUTRAL] company, you need to call the patient to verify if they have any other insurance. They don't have any active policies with our company.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] OK. So what's the policy?
[CUSTOMER][NEUTRAL] What's the policy effective on term date?
[AGENT][NEUTRAL] Effective date [PII], term date [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Same day?
[CUSTOMER][NEUTRAL] Effective one term date?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. So what's the claim number?
[AGENT][NEUTRAL] 352-793-2
[CUSTOMER][NEUTRAL] OK. And what's the reference number?
[AGENT][NEUTRAL] Uh, if you like, you may use my name at today's date.
[CUSTOMER][NEUTRAL] It's A K E K E K and today's date, right?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] [PII] E K E last initial [PII] and today's date.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] It's [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And today's date.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. Thanks for your cooperation. Have a great day. Bye-bye. Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Bye.