AccountId: 011433970860
ContactId: 05a39e04-f5df-4c56-afdb-18b96747e047
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305059 ms
Total Talk Time (AGENT): 92671 ms
Total Talk Time (CUSTOMER): 78636 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/05a39e04-f5df-4c56-afdb-18b96747e047_20250625T20:55_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Grandstand.
[AGENT][NEUTRAL] I'm sorry, ma'am, I cannot hear you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Can I, is it OK now?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, hi. This is [PII] calling from Granton Medical Center to check on a claim status.
[AGENT][NEUTRAL] OK, and [PII], what is that policy number, please, to verify claim status for you.
[CUSTOMER][NEUTRAL] 02506178
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Um, the patient name [PII].
[CUSTOMER][NEUTRAL] Date of birth, [PII].
[AGENT][NEUTRAL] OK, thank you and what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII]. And the charge amount, one moment, charge amount.
[CUSTOMER][NEUTRAL] Um, $19,942 even.
[AGENT][NEUTRAL] And the balance after primary?
[CUSTOMER][NEUTRAL] Balance
[CUSTOMER][NEUTRAL] $5,762.40.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Uh, it looks like the claim process initially is needing primary EOB. It looks like it was processed the second time as insurance primary paid in full. There are no benefits payable.
[CUSTOMER][NEUTRAL] Can I have the resident process date?
[AGENT][NEUTRAL] Uh, one moment.
[AGENT][NEUTRAL] OK, so the claim received [PII], claim processed on [PII].
[CUSTOMER][NEUTRAL] Uh, so, primary.
[CUSTOMER][NEUTRAL] Uh, so what about the balance amount?
[AGENT][NEUTRAL] Well, we can't give patient responsibility. We can only verify how the claim was processed. Per the explanation benefits of the primary does not show they applied any amount towards deductible, co-pay or co-insurance, so there's nothing for us to pick up as secondary.
[CUSTOMER][NEUTRAL] Um, OK, one moment, let me check.
[CUSTOMER][NEUTRAL] Um, actually, we are sending deductible amount, um.
[AGENT][NEUTRAL] Not on the EOB we received. So if you have an EOB that shows the amount was applied towards the deductible, you can resubmit that to us for review.
[CUSTOMER][NEUTRAL] Can I send
[CUSTOMER][NEUTRAL] Uh, we already sent it.
[AGENT][NEUTRAL] Well, what we received does not show any amounts applied towards deductible, co-pay or co-insurance, so.
[CUSTOMER][POSITIVE] OK, we will send it again, no issues.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Hey, is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Yes, can I have the fax number or mailing address to send you a copy of the email?
[AGENT][NEUTRAL] Sure, fax number 877365-[PII].
[CUSTOMER][POSITIVE] OK. Thank you for assisting. Have a great day. And uh also I just need to call.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Uh, you may use my name in today's date for call reference, and it's [PII] Q.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, bye. You're welcome. Bye.
[CUSTOMER][POSITIVE] Thank you.