AccountId: 011433970860
ContactId: f1ce0647-0ca4-447d-9dcb-12d187bfe704
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 361630 ms
Total Talk Time (AGENT): 125839 ms
Total Talk Time (CUSTOMER): 164583 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/f1ce0647-0ca4-447d-9dcb-12d187bfe704_20250115T18:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I'm calling on behalf of Brownsville Hospital for a claim status.
[AGENT][NEUTRAL] OK, yeah, I can check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] It's [PII] and my last name initial is [PII].
[AGENT][NEUTRAL] OK, and then can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII], no extension number.
[AGENT][NEUTRAL] Thank you. And did you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 018688884.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII]. Total charge is $29,060 even.
[AGENT][NEUTRAL] $29,060.
[CUSTOMER][NEUTRAL] Today
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK, was the remaining balance, uh, after major medical paid, was that $4,934.91?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, OK, so I did find this claim looks like we paid a benefit of $2550.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So give me one moment I'll get that information.
[AGENT][NEUTRAL] Did you need that claim number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh yeah, sure.
[AGENT][NEUTRAL] OK, claim number is 33.
[AGENT][NEUTRAL] 82
[AGENT][NEUTRAL] 500.
[CUSTOMER][NEUTRAL] Mhm, OK.
[AGENT][NEUTRAL] OK and then did you need the check number as well?
[CUSTOMER][NEUTRAL] Uh, no, actually I do have, um, a question regarding this claim since we already, uh, um, we called last time.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, for the status of the medical records that we sent.
[AGENT][NEUTRAL] Medical records uh for this claim?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, because we sent it last [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm not showing that we received anything like that.
[CUSTOMER][NEUTRAL] OK. Can you please uh verify, let me just pull up the information if we do have here the reference number.
[AGENT][NEUTRAL] Well, I'm sorry, what was the
[AGENT][NEUTRAL] Sure, what were the records regarding for this claim or for a separate claim?
[CUSTOMER][NEUTRAL] Uh, no, for, for this claim because it's showing here that um there has been a underpayment.
[CUSTOMER][NEUTRAL] And the insurance requested for the complete medical records to review.
[AGENT][NEUTRAL] OK, um, well, let's see, I have the $2550 and met their maximum amount that we were able to pay.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it's already here.
[CUSTOMER][NEUTRAL] OK. And also, [PII], is it possible for us to um request for this uh um explanation of benefits saying that the allowable. OK, thank you.
[AGENT][POSITIVE] Of course, yeah, I can send that to you.
[AGENT][NEUTRAL] Absolutely did you have a fax number?
[CUSTOMER][NEUTRAL] Yes, we do have.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[CUSTOMER][POSITIVE] And kindly please attend, oh sure.
[AGENT][NEUTRAL] OK, I'm gonna read that back.
[AGENT][NEUTRAL] Oh sure sorry who's attention? sorry.
[CUSTOMER][NEUTRAL] Um, please attention the fax to this number. It's um, gonna be the patient number 108011438.
[AGENT][NEUTRAL] OK, so I've got that fax number as [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] And then I've got the attention attention is going to be 108011438.
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] OK, OK, perfect. I will go ahead and get that sent to you now. Uh, should get it here in maybe 10-15 minutes depending on how busy your machine is. Uh, was there anything else I could help you with, man?
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Um, I think there's none. Um, can I have your last name initial, please, [PII]?
[AGENT][NEUTRAL] Sure my last initial is A.
[CUSTOMER][POSITIVE] OK, perfect. And how about the reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] OK, I think this all the information that I need, [PII]. Uh, we will just wait for the documents to be received. Thank you so much for assisting me. It's such a great help.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too take care bye bye.
[AGENT][POSITIVE] Thank you, bye bye.