AccountId: 011433970860
ContactId: c093a5dc-cc97-4db5-b150-e1bff375c70d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 306269 ms
Total Talk Time (AGENT): 68494 ms
Total Talk Time (CUSTOMER): 87250 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/c093a5dc-cc97-4db5-b150-e1bff375c70d_20250521T14:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] How you doing [PII]?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][POSITIVE] I'm doing great. My name is [PII]. I'm calling from Memorial Herman Hospital, and I'm calling to check status on the claim.
[AGENT][NEUTRAL] Hey, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you. And what's the policy number for that patient?
[CUSTOMER][NEUTRAL] It's 02573163.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And date of service and bill charges.
[CUSTOMER][NEUTRAL] Data services [PII] for total charge.
[CUSTOMER][NEUTRAL] Um, $10,137 even.
[AGENT][NEUTRAL] It looks like we received that claim on 3-10-2025.
[AGENT][NEUTRAL] This process 311.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Uh, looks like we need a copy of the explanation of benefits from the primary insurance.
[CUSTOMER][NEUTRAL] OK, we're not showing that they have any other insurance.
[AGENT][NEUTRAL] Uh, let me see what we have on file.
[AGENT][NEUTRAL] Uh, we show UnitedHealthcare.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Not, OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1 2nd.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Do you have the claim number?
[AGENT][NEUTRAL] Uh, yes, hold on one moment.
[AGENT][NEUTRAL] Uh, that claim number is 3574068.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, give me one second.
[CUSTOMER][NEUTRAL] I apologize.
[AGENT][NEUTRAL] Oh, you're fine.
[CUSTOMER][NEUTRAL] I'm just trying to see something.
[CUSTOMER][NEUTRAL] And was that the information she updated you all with or is that?
[AGENT][NEUTRAL] Uh, we just received it from the employer.
[AGENT][NEUTRAL] So group policy, so.
[CUSTOMER][NEGATIVE] Yeah, because under United Healthcare, they, they're not showing active. They're showing inactive on that data service.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, this is a secondary policy, so we'd have to have the primary EOB in order to process. So, um, we just want to contact the patient and get more information.
[CUSTOMER][NEUTRAL] Oh, so
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, OK, so she'll just have to update. So basically, this is a secondary policy like you said, so she has to have a primary or you all won't cover.
[AGENT][NEUTRAL] Yes, it is.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, well thank you very much, [PII] you have a uh reference number?
[AGENT][NEUTRAL] It's just my name, [PII], first initial to last name, [PII], and today's date. And anything else I can help with today?
[CUSTOMER][POSITIVE] No, just have a great day and enjoy the rest of your week.
[AGENT][POSITIVE] OK, well, thank you for calling [PII]. I hope you do as well.
[CUSTOMER][NEUTRAL] OK, bye.
[AGENT][POSITIVE] Thank you. Bye.