AccountId: 011433970860
ContactId: baaba54d-fc3e-49be-985f-2f2a0ff35fff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 338480 ms
Total Talk Time (AGENT): 111215 ms
Total Talk Time (CUSTOMER): 73762 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/baaba54d-fc3e-49be-985f-2f2a0ff35fff_20250611T21:06_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from TNC Bonham Hospital, and I was just needing to verify if there's a claim on file for a patient.
[AGENT][NEUTRAL] OK, well, I'll be more than happy to assist you with seeing if there's a claim on file. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, it's a direct line of [PII].
[CUSTOMER][NEUTRAL] And the member ID I have is.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] It was for [PII] total charges $2,986 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] It is TMC Bonham Hospital.
[AGENT][NEUTRAL] What's your tax ID?
[CUSTOMER][NEUTRAL] Or Fannin County.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEUTRAL] OK. You are on hold.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Are there any others?
[AGENT][NEUTRAL] 82.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] All right, thank you so much for holding. I do apologize for that wait. Um, so we did receive the claim, um, we received the claim, hold on one second, on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Claim number is 361.
[AGENT][NEUTRAL] 0826.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], um, the charge of the 2986, I'm sorry.
[AGENT][NEUTRAL] $2,986 was denied because the benefit for the, the benefit maximum for the data service has been met.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And so that's probably on our on its way to us the EOB since it was just last week or is it the beginning of this week, yeah.
[AGENT][NEUTRAL] Um, yes, the explanation of benefits is on the way to you. Hold on one moment, let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, it mailed out on the [PII].
[CUSTOMER][NEUTRAL] OK, right, and I'm sorry, can I get your name again?
[AGENT][NEUTRAL] Sure, my name is [PII], [PII] initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, it was it
[CUSTOMER][NEUTRAL] Alright and then.
[AGENT][NEUTRAL] Was there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][POSITIVE] If I could just get a reference number that'll be great.
[AGENT][NEUTRAL] All right, so there's no call reference number, but you can use my name in today's date. The first initial to my last name again is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's all I needed.
[AGENT][POSITIVE] Alrighty well thank you so much for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.