AccountId: 011433970860
ContactId: f34aa59e-f1f0-4f83-a6df-e81d6a94e961
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326790 ms
Total Talk Time (AGENT): 163275 ms
Total Talk Time (CUSTOMER): 116579 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/f34aa59e-f1f0-4f83-a6df-e81d6a94e961_20250130T20:01_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. We um got a letter from Thibodaux Regional Medical Center stating that they were informed by the insurance company that a bill was denied because they need coordination of benefits. This is for [PII].
[AGENT][NEUTRAL] OK, and may I have your name?
[CUSTOMER][NEUTRAL] That's I should have started with that.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And Mrs. Well, may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And the phone number is [PII].
[CUSTOMER][NEUTRAL] And the policy number is 21.
[CUSTOMER][NEUTRAL] 80311
[AGENT][NEUTRAL] Thank you. Hold on one moment while I pull up that policy. So there was a claim that was denied and it's saying that something about coordination of benefits.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I have it here. Hold on one moment. I'm just pulling the policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and um you were on the policy as well. I just need you to verify your date of birth and the mailing address.
[CUSTOMER][NEUTRAL] OK, my date of birth is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment.
[AGENT][NEUTRAL] Um, and you said that this is for Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am. The date would be.
[AGENT][NEUTRAL] OK. On the OK.
[CUSTOMER][NEUTRAL] The date would be [PII].
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And just for the call, all the information provided is a verification of benefits, not a guarantee of payment.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] So, I was um
[AGENT][NEUTRAL] I want to tell you to disregard that letter and the reason is because this claim has been paid out. I don't know if that was at one point the reason.
[AGENT][NEUTRAL] You know, like it was waiting for a coordination or um eligibility, but now everything for this data service has been paid. Um, what's the total bill for that letter that you have?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] The total bill was, OK, the total bill was $553.
[AGENT][NEUTRAL] OK, let me see if it is.
[CUSTOMER][NEUTRAL] Now I
[AGENT][NEUTRAL] Oh, go ahead, I can still hear you.
[CUSTOMER][NEUTRAL] Oh, OK, I just got off the phone with Allied and they said they paid on that claim.
[AGENT][NEUTRAL] Mhm. They were probably waiting for a primary then us and um, but, but I just want to double check, hold on one second, 438.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] And what's the other one for that date?
[AGENT][NEUTRAL] 464.
[AGENT][NEUTRAL] 553. OK, so yes, everything has been paid. Um, it just finished processing on [PII], so that letter probably was sent while, you know, and it got intercepted, but this has been paid to the provider, um, a total, well,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like it's the same thing. One is just the facility charge and one is for the treatment. Um, so for the one that's listed as facility for Thibodaux Regional, we paid them $767.30 for that one because it was only $2 for this day. And then the other one.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It be for a doctor.
[AGENT][NEUTRAL] Uh, this is for the doctor and the treatment. Yes, you're right, it's for the treatment and the doctor. Um, we paid $168.73 but that's because they didn't bill us for 553. Um, they billed us for the 16873 cents.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] So we paid the whole thing.
[CUSTOMER][POSITIVE] OK, so it's all paid out, so I don't have to worry about it.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you, ma'am.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] when I can.
[CUSTOMER][NEGATIVE] No, that's it. When I got that letter, I said, wait, I don't understand that. And the letter was dated was dated [PII]. I said, well, wait, if that was at the beginning of the year, or even in November, December, he was on Medicare Part B. So why I'm getting
[CUSTOMER][NEUTRAL] A letter stating, but now I understand why it was all the way since August.
[AGENT][POSITIVE] Yes, ma'am. So everything is good to go. Are you sure you don't have any other questions or anything?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Not at this time, dear. Thank you so much, and you have been a big help.
[AGENT][POSITIVE] You're welcome, Mrs. [PII]. Well, thanks for calling APL and I hope you have a great day.
[CUSTOMER][POSITIVE] You too, dear. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.