AccountId: 011433970860
ContactId: c65ff665-3dc4-47df-9d44-2f55e4576ee2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 271980 ms
Total Talk Time (AGENT): 101315 ms
Total Talk Time (CUSTOMER): 104707 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/c65ff665-3dc4-47df-9d44-2f55e4576ee2_20250602T13:49_UTC.wav
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[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hello. Good morning. This is [PII]. I'm calling from UT Southwestern Medical Center, and I'm looking for a claim status, please.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with claim status. Um, first, could I get your name again and I'll go callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. It's [PII] Um my phone number will be [PII], no extension.
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I, let's see, get the policy number, please?
[CUSTOMER][NEUTRAL] Yes, it's um 02449815.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um, her name is [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, thank you. Now, I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Um, yes, just a second. Well the data of service is [PII] and the available amount is 11,0874.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] today
[AGENT][NEUTRAL] OK. Thanks for your patience. Um, I'm showing that we received this claim on [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And the claim was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, the claim number is 35801999.
[AGENT][NEUTRAL] And I'm showing that this claim denied because under this policy, let's see, for outpatients.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let's see how much we cover. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We cover up to 2000 per calendar year, and that benefit maximum was reached on a previous claim.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And did I give you the claim number?
[CUSTOMER][NEUTRAL] Mhm
[AGENT][POSITIVE] OK, great.
[CUSTOMER][NEUTRAL] Alright, so that means that there's gonna be patient responsibility remaining balance, right?
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] OK, one more question, um, the claim was sent to, let me see, this PO box, it's a [PII].
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um, for, to us? No, ma'am. That's not, that's not our mailing address.
[CUSTOMER][NEUTRAL] Can you please
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] That's not our mailing address.
[CUSTOMER][NEUTRAL] No, no, no, no, no, I'm talking about.
[CUSTOMER][NEUTRAL] No, that's our actually. I just wanna check if, if it, if the EOB was sent to that address to that POS.
[AGENT][NEUTRAL] OK, one moment. Let me see what address was on the claim. OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, yeah, the address on the claim UT Southwestern Medical Services [PII].
[CUSTOMER][NEUTRAL] Medical services.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am. That's where it was sent.
[CUSTOMER][POSITIVE] Yes, yes, yes, that's the one, thank you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK perfect can I have your name one more time please and also a reference number?
[AGENT][NEUTRAL] Yes, ma'am. My name is [PII]. It's spelled [PII] Last initial is [PII] like [PII] and my name and today's date is the reference number. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] No, no, no, thank you so much you have a wonderful day, OK?
[AGENT][POSITIVE] You do the same, friend. Thank you for calling ATI mhm bye.
[CUSTOMER][NEUTRAL] Bye for now.
[CUSTOMER][NEUTRAL] Bye bye.