AccountId: 011433970860
ContactId: df73b799-f65b-4a55-9565-b7e997e57dce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 376299 ms
Total Talk Time (AGENT): 180853 ms
Total Talk Time (CUSTOMER): 125626 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/df73b799-f65b-4a55-9565-b7e997e57dce_20250604T15:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for contacting UT. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I am calling in regards to a patient's claim.
[AGENT][NEUTRAL] Uh, yes, I can certainly have a what's that policy number, please?
[CUSTOMER][NEUTRAL] Yes, I have 02573210.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient's name is [PII] or [PII]. Date of birth is [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. What date of service are we looking for from this paper?
[CUSTOMER][NEUTRAL] Day of service is [PII] and uh we billed $394.
[AGENT][POSITIVE] OK, yeah. Thank you and uh.
[AGENT][NEUTRAL] OK, so the claim number is 3591738.
[AGENT][NEUTRAL] We are a secondary or gap insurance.
[AGENT][NEUTRAL] And what we're looking for is the explanation of benefits from her major medical.
[AGENT][NEUTRAL] Which, um, I'm not really sure who that is, uh.
[AGENT][NEUTRAL] But that is what we would need in order to to finish processing your claim, that we would need the explanation of benefits from her primary insurance which shows the deductible co-payment of coin insurance.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's what we would need to uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Know what we need to pay now, is there anything in particular besides that that we could help with or?
[CUSTOMER][NEUTRAL] Uh, no, that was it. Just wondering, uh, we didn't receive any kind of documentation, uh, or any kind of correspondence or anything, um, stating like a denial or was something sent out?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am, it was, uh, that looks like we received that on the [PII] and we processed it on the [PII]. I would be more than glad to fax that to you if you want to give me your fax number.
[CUSTOMER][NEUTRAL] Uh, is it possible for you to, um, email it?
[AGENT][NEUTRAL] I wish that I wish that we did. We're actually, um, uh, our online service center is actually under construction right now that may be something that we can do, but right now I would rather have to fax it to you or mail it to you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, um, um, yes, we, you can fax it, but, um, also I have another claim for the same patient if, if we can get that first.
[AGENT][NEUTRAL] Yes, of course. What is the uh service date on that?
[CUSTOMER][NEUTRAL] Uh, for that 11 moment, sorry, as I was talking, um.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, that one is data er I think I gave you the data services of 34, um, this one is for 311.
[AGENT][NEUTRAL] And is there a particular building that we need to look at?
[CUSTOMER][NEUTRAL] We uh billed for this 1 $535.
[AGENT][NEUTRAL] OK, thank you. The claim number for this one is 35.
[AGENT][NEUTRAL] 95814.
[AGENT][NEUTRAL] Now, on this plan, this is a little different, um, the policy doesn't cover that office visit.
[CUSTOMER][NEUTRAL] 14
[AGENT][NEUTRAL] So, um, that was denied, uh, because it, uh, the policies is for in and out of hospital settings, um, not, uh, for anything within the physician's office, and it looks like we received that, um, particular claim.
[AGENT][NEUTRAL] Let's see if I can find that. It looks like we received that on [PII] and process it on [PII]. I can send you the EOB on that one as well. Um, it's just that that that those, uh, services are not covered.
[CUSTOMER][NEUTRAL] OK, thank you for that. And I'm sorry, I do have, um, I apologize. I do have another one for this patient also. She actually has 3, as I'm looking at it. Um, one moment, let me pull that one up.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, that one's for $220 of 2025 and we billed $270.
[AGENT][NEUTRAL] OK. Um, the claim number on this particular one, is 359.
[AGENT][NEUTRAL] 1732. Now again, uh this is uh something where the uh policy was uh does not cover this offices it's copay, uh.
[AGENT][NEGATIVE] It's just not covered so that's that was sent out um but it doesn't have uh.
[AGENT][NEUTRAL] Any benefits in our in our system so.
[AGENT][NEUTRAL] What we did was we had to send it tomorrow on that.
[AGENT][NEUTRAL] That I can also send you a copy of uh of that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I appreciate it. Um, our fax number is 423.
[CUSTOMER][NEUTRAL] 485.
[CUSTOMER][NEUTRAL] 661 9.
[AGENT][POSITIVE] OK, I will certainly fax those EOB to you. Now, is there anything else that I can help with?
[CUSTOMER][NEUTRAL] No, that was it. Um, do you uh have call reference numbers?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We will use that today's date of our.
[CUSTOMER][POSITIVE] All right, thank you again and um.
[CUSTOMER][NEUTRAL] Just allow, I guess 24 hours for that or?
[AGENT][NEUTRAL] That's usually about how long it will take to have this fold in fact.
[CUSTOMER][POSITIVE] OK. Thank you again. You have a wonderful day.
[AGENT][POSITIVE] Thank you for contacting us too. Have a good day.