AccountId: 011433970860
ContactId: dd3df4f7-0ecf-46e7-80f0-7bdfb50ec7e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 273750 ms
Total Talk Time (AGENT): 103020 ms
Total Talk Time (CUSTOMER): 104598 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/dd3df4f7-0ecf-46e7-80f0-7bdfb50ec7e8_20250304T13:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. This is [PII] calling from US anesthesia Partners of Texas checking on a claim status. How are you doing today?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][POSITIVE] I'm doing great thanks for asking.
[AGENT][NEUTRAL] I'm sure, [PII] I can assist you. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. My callback number is [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, sure. So the number is 0225.
[CUSTOMER][NEUTRAL] 2830 M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] The patient name is uh [PII], and the date of birth of the member is [PII].
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII], and this policy expired on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So the patient got uh termed on [PII], right?
[AGENT][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Mm, got it.
[AGENT][NEUTRAL] OK. And is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Yes, I want to uh just check the claim status for the date of service.
[AGENT][NEUTRAL] OK. And what's the date of service and bill charges for the claim?
[CUSTOMER][NEUTRAL] The total charge, uh, the date of service is [PII]. And the total charge amount of this claim is, uh,
[CUSTOMER][NEUTRAL] One moment, yeah, it's $4,698 even.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][POSITIVE] No problem take care.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Thanks for your patience. I'm showing that we received this claim on [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 3252425.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the claim denied because we need the EOB from the primary insurance company.
[CUSTOMER][NEUTRAL] Oh, actually, uh, for this claim, you guys are the primary for the patient.
[AGENT][NEUTRAL] No, we're secondary, ma'am.
[CUSTOMER][NEUTRAL] How did you receive any coordination of benefits for that since stating you're the secondary?
[AGENT][NEUTRAL] Well, we sent an EOB to the provider letting them know that we're secondary and we need the um the EOB from the primary insurance company.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so USC is the primary for this number, is it right?
[AGENT][NEUTRAL] We're secondary, ma'am. We're secondary insurance for the member. And we need the EOB from the primary insurance company.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, ma'am. May I know the reference number for this call, please?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII], um it's spelled [PII] My last initial is [PII] and today's date. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] Uh, no, ma'am. Thank you so much for assisting me today. Have a great day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling ATL. um bye.