AccountId: 011433970860
ContactId: d8631d6f-0eb8-41e1-818c-d016ecb25705
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 381859 ms
Total Talk Time (AGENT): 110498 ms
Total Talk Time (CUSTOMER): 88647 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/d8631d6f-0eb8-41e1-818c-d016ecb25705_20250116T17:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from A.
[AGENT][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] Yeah, hi.
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling from Ashram Medical Center.
[CUSTOMER][POSITIVE] Have a good day today?
[AGENT][POSITIVE] And it is, I'm having a great day. How are you? How are you today, [PII]?
[CUSTOMER][NEUTRAL] So far so good but sleepy it's all right.
[AGENT][NEUTRAL] OK, can I get your callback number just in case our call gets disconnected?
[CUSTOMER][NEUTRAL] OK, sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII] it's a direct line.
[AGENT][POSITIVE] Thank you, sir. And then.
[AGENT][NEUTRAL] Can I help you today?
[CUSTOMER][NEUTRAL] So I am here for a claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status. What is the patient's name?
[CUSTOMER][NEUTRAL] Um, patient's name is [PII].
[CUSTOMER][NEUTRAL] Uh sorry, it's [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. And what's [PII]'s uh date of birth?
[CUSTOMER][NEUTRAL] Date of birth. It's [PII].
[AGENT][NEUTRAL] OK, and the policy number, please?
[CUSTOMER][NEUTRAL] It's 1,360,000.
[AGENT][NEUTRAL] 136,000.
[CUSTOMER][NEUTRAL] It's 40 at the end 136 and 40s.
[AGENT][NEUTRAL] OK, let me look that policy.
[AGENT][NEUTRAL] OK, I do find Jean. What is the date of service?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] is $1,356.
[AGENT][NEUTRAL] OK and then what is charged after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Um, you are the primary.
[AGENT][NEUTRAL] Right, the charge after the primary insurance paid their part.
[CUSTOMER][NEUTRAL] No, this claim is, uh, billed as a primary acting US acting primary.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right, [PII], I'm gonna put you on a brief hold and you said you're with Oschner's Medical Center, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm gonna put you on a hold. I'm gonna look up that claim and I'll be right back.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], this is [PII] back with you again. So I did file a claim.
[CUSTOMER][NEUTRAL] OK, sorry.
[AGENT][NEUTRAL] I found the claim and the claim the claim number is 341-7845.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim denied because the services were rendered after the policy terminated.
[AGENT][NEUTRAL] And the policy terminated on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And there are no other active.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, and there's no other active policies.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, when is, when it is effective? Do you have an effective date?
[AGENT][NEUTRAL] Yes, the effective date, the original effective date of the policy was [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]. All right. And you said the member have no other active coverage, correct?
[AGENT][POSITIVE] Right, that's correct.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] OK [PII] and yeah that's it. Thank you for the information. Can I get the call reference please?
[AGENT][NEUTRAL] Yes, you can use my name and today's date.
[CUSTOMER][POSITIVE] Thank you, [PII]. Thank you for helping me. Have a great day.
[AGENT][POSITIVE] You're welcome, [PII]. You have a great day too. Thanks for calling APL.
[AGENT][NEUTRAL] Bye-bye, sir.
[CUSTOMER][NEUTRAL] Yeah bye bye.
[CUSTOMER][NEUTRAL] Yeah.