AccountId: 011433970860
ContactId: 0fb9a5ed-35af-4196-8ae7-48f91a408f15
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 432559 ms
Total Talk Time (AGENT): 164093 ms
Total Talk Time (CUSTOMER): 163166 ms
Interruptions: 1
Overall Sentiment: AGENT=1.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/0fb9a5ed-35af-4196-8ae7-48f91a408f15_20250410T14:15_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] calling from the provider office to check on a client's status. How are you doing today?
[AGENT][POSITIVE] I am doing fine, thank you for asking. And how can you, do you mind spelling your name?
[AGENT][NEUTRAL] For your documentation.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] [PII].
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII] is a good callback number?
[CUSTOMER][NEUTRAL] It is [PII]. You got it?
[AGENT][POSITIVE] Yes, sir. I've got it, [PII]. Thank you.
[CUSTOMER][NEUTRAL] I'll do that at all.
[AGENT][NEUTRAL] And [PII], what is the patient's policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, just give me one. It is 02.
[CUSTOMER][NEUTRAL] 356-084
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Thank you. And [PII], what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yes, it is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Alright, thank you, [PII], it would be my pleasure to assist you with that claim status. Do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, I'll tell the date of service it is [PII] with the total bill amount of 25,457.2 cents.
[AGENT][NEUTRAL] And you said
[AGENT][NEUTRAL] What was that date of service again?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] March to then.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm checking on that claim, bear with me just one second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] And you, and you said the bill amount do you mind repeating that one more time?
[CUSTOMER][NEUTRAL] It is 254-57.62.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm checking on that claim. Bear with me just one second. What is the facility name, please?
[CUSTOMER][NEUTRAL] Mm yeah.
[CUSTOMER][NEUTRAL] Just uh just one second.
[CUSTOMER][NEUTRAL] It is Piedmont Augusta Hospital.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] I did locate that claim.
[AGENT][NEUTRAL] [PII], looks like we've received the claim several times. I can give you the paid claim information.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] Yes, uh, the claim has been denied for duplicate. I just want to know the original claim status.
[AGENT][POSITIVE] It would be my pleasure to assist you. So, we received the
[CUSTOMER][NEUTRAL] Can you please spell your name for me?
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And when
[CUSTOMER][NEUTRAL] OK, can you please tell me the information now?
[AGENT][NEUTRAL] Sure. We received that claim claim on [PII], processed on [PII].
[AGENT][NEUTRAL] And with the payment of $348.15 to Piedmont Augusta Hospital.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, can you please tell me the a loan amount?
[AGENT][NEUTRAL] Yeah, the benefit amount is $1500 per calendar year. Now we don't reprice claims, but that's the benefit amount, and that is a verification of coverage, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Paid amount is 348.15 right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, and the allowed amount is?
[AGENT][NEUTRAL] Well, we don't reprice claims, but I can give you the benefit amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much and uh.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] We're secondary to the major medical.
[CUSTOMER][NEUTRAL] I just want my, I just want to know.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Yes, yes, I understood.
[CUSTOMER][NEUTRAL] And um can you please tell me through which it has been paid?
[AGENT][NEUTRAL] Single excuse me, single paper check.
[CUSTOMER][NEUTRAL] Can you please tell me the check number?
[AGENT][NEUTRAL] 1850626.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, and uh.
[CUSTOMER][NEUTRAL] Can you please tell me it's a bulk or it's a single check?
[AGENT][NEUTRAL] Single paper check.
[CUSTOMER][NEUTRAL] For the amount of 348.15 cents right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] O
[CUSTOMER][NEUTRAL] OK and uh.
[CUSTOMER][NEUTRAL] Can you please tell me when it has been issued, the check has been issued.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Is it?
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yes, the clear date also the same as [PII].
[AGENT][NEUTRAL] The clear date is [PII].
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK and uh can you please verify the pay to address.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] But the check has been issued.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, alright, thank you so much for your kind information, ma'am, and uh, can you please provide the call reference?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Call reference number is my name and today's date. And would you also like that claim number, [PII]?
[CUSTOMER][POSITIVE] Yep, yep, of course.
[AGENT][NEUTRAL] The claim number is 345.
[AGENT][NEUTRAL] 226 2.
[CUSTOMER][NEUTRAL] OK, it's 345.
[CUSTOMER][NEUTRAL] 2262, that's it, right?
[AGENT][POSITIVE] Yes sir, that's correct.
[CUSTOMER][NEUTRAL] OK, [PII] and uh.
[CUSTOMER][NEUTRAL] I think that's it for the day, OK?
[AGENT][POSITIVE] Well, it has been a pleasure.
[CUSTOMER][POSITIVE] How wonderful and beautiful.
[AGENT][POSITIVE] I hope you have a wonderful day as well, [PII]. It was a pleasure to assist you. Thank you for calling APL. Take care.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bye bye.