AccountId: 011433970860
ContactId: 083394fb-e016-4a5a-9208-51a0525ff282
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266910 ms
Total Talk Time (AGENT): 85860 ms
Total Talk Time (CUSTOMER): 64460 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/083394fb-e016-4a5a-9208-51a0525ff282_20250528T16:36_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, this is [PII] from Holy Cross Hospital. I'm checking status on the claim.
[AGENT][NEUTRAL] And you said you you're calling from what hospital?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] For claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and [PII], can I get a good phone number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII] direct?
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] The policy number I have is 01887317ML8.
[AGENT][NEUTRAL] 180188731
[CUSTOMER][NEUTRAL] 7 ML 8.
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] And can I get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the claim number or the date of service?
[CUSTOMER][NEUTRAL] Data service I have is 425 25 and 95 $716.66.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They melt it out, um.
[CUSTOMER][NEUTRAL] Yeah, they mailed it out on [PII].
[CUSTOMER][NEGATIVE] And they melted to.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII], I guess, uh, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said it was for 9, I'm sorry 95,000?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] OK, Ms. [PII], I have the claim number is 36.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 01
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 586.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We received this claim on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It looks like that claim was denied, and let me see why.
[AGENT][NEUTRAL] OK, it looks like we need um a copy of the explanation of benefits from the primary insurance carrier.
[AGENT][NEUTRAL] Because this is a secondary gap policy, so we will need the EOB from the primary insurance to show that they paid some benefits first.
[CUSTOMER][NEUTRAL] Do they say who the primary is?
[AGENT][POSITIVE] I can look that up for you.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] It looks like it's Cigna.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] All righty then, give me a reference for the call.
[AGENT][NEUTRAL] OK, we don't have reference numbers, but you can use my name and last initial in today's date, so [PII]
[CUSTOMER][NEUTRAL] What's your last initial? Uh-huh. OK. All right.
[AGENT][NEUTRAL] [PII] and today's date.
[CUSTOMER][POSITIVE] You have a good day.
[AGENT][POSITIVE] Thank you for calling APL have a great day.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye.