AccountId: 011433970860
ContactId: 1479a6ee-5368-4876-a7d0-7509b4223f34
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 338140 ms
Total Talk Time (AGENT): 122894 ms
Total Talk Time (CUSTOMER): 119202 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/1479a6ee-5368-4876-a7d0-7509b4223f34_20250127T16:14_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] My name is [PII], calling from Northwest Community Hospital calling regarding a claim.
[AGENT][POSITIVE] It would be my pleasure to assist you, [PII]. What is the callback number?
[CUSTOMER][NEUTRAL] Direct is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, [PII] and the policy number for the patient.
[CUSTOMER][NEUTRAL] 02277916
[AGENT][NEUTRAL] And the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][POSITIVE] All right, thank you, and it would be my pleasure to assist you with claim information.
[AGENT][POSITIVE] Are you needing claim status or do you have a claim number? OK, yes, that'd be my pleasure.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Claim status.
[AGENT][NEUTRAL] And what is that data service?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the bill amount?
[CUSTOMER][NEUTRAL] $615.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And the name of the facility?
[CUSTOMER][NEUTRAL] Northwest Community Hospital.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Now [PII], I am showing that we received that claim on [PII].
[AGENT][NEUTRAL] It was processed on [PII] and it is pending for the primary EOB. We are secondary to their major medical.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] Should have been sent over when we sent over the claim.
[AGENT][NEUTRAL] OK, let me pull up the documents just to make sure.
[CUSTOMER][NEGATIVE] Not saying it was. It should have been.
[AGENT][NEUTRAL] I hear you.
[AGENT][NEUTRAL] Yeah yeah.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] What was sent him what cannot confirm or deny if they did.
[AGENT][NEUTRAL] Yeah, but I don't mind checking it.
[CUSTOMER][NEUTRAL] I'm trying to pull it up on my end too.
[CUSTOMER][NEUTRAL] See if we had it.
[AGENT][NEUTRAL] It's coming up slowly but surely.
[CUSTOMER][NEUTRAL] I hear you. Oh, seriously you gonna play with your toy right now? OK.
[AGENT][NEGATIVE] Oh, come on.
[CUSTOMER][NEUTRAL] If not, if there's a way I can fax it or something.
[AGENT][POSITIVE] Oh yeah, absolutely. Let me check this document though because I see.
[AGENT][NEUTRAL] Hang on just a second.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] What do you show as the deductible?
[CUSTOMER][NEUTRAL] Um, Blue Cross Blue Shield left them a
[CUSTOMER][NEUTRAL] $200.49. Let me see if they put that to deductible if it was something else. Let's see.
[AGENT][NEUTRAL] Looks like they did.
[CUSTOMER][NEUTRAL] Yep went to deductible.
[AGENT][NEUTRAL] OK, do you mind holding just one moment? Let me get you to our claims department because I believe that.
[AGENT][NEUTRAL] This EOB will suffice and let's just verify that, OK?
[CUSTOMER][NEUTRAL] This
[CUSTOMER][POSITIVE] OK thanks.
[AGENT][POSITIVE] Thank you one moment please, ma'am.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][POSITIVE] Thanks for calling AO. This is [PII]. How may I assist you?
[AGENT][POSITIVE] Hey, [PII], this is [PII]. How are you doing? Happy Monday.
[CUSTOMER][POSITIVE] Hey [PII], I'm good. How are you?
[AGENT][NEUTRAL] I'm doing well thank you. I have a provider on the line. She was calling for claim status. We were denying for primary EOB and she said it was sent in with the claim. Can you check that?
[CUSTOMER][NEUTRAL] What's the policy number?
[AGENT][NEUTRAL] 227-7916
[AGENT][NEUTRAL] For [PII].
[CUSTOMER][NEUTRAL] And which claim is she calling about?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] 3542736 and I do have a callback number if you'd like.
[CUSTOMER][NEUTRAL] The [PII]
[AGENT][NEUTRAL] Well, actually, she gave me a different phone number.
[CUSTOMER][NEUTRAL] What's the number?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you and you said this is the member?
[AGENT][NEUTRAL] And this a provider [PII].
[CUSTOMER][POSITIVE] OK, you can send her over [PII]. Thank you.
[AGENT][POSITIVE] OK. Thank you, [PII]. Let me get her on the line. You have a wonderful day.
[CUSTOMER][POSITIVE] You do just fine. Thank you.
[AGENT][POSITIVE] Good to see you tomorrow.
[CUSTOMER][POSITIVE] Yes, ma'am, I sure would be.
[AGENT][POSITIVE] All right. All right. Good deal. You take care. One moment.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] Hey [PII], how you doing?
[CUSTOMER][NEUTRAL] [PII], sorry. Hello, [PII]?
[CUSTOMER][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] How you doing? My name is [PII] and, and I'll be assisting you. You're calling in regards to claim for data service [PII].
[CUSTOMER][NEUTRAL] Correct, um, no, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I, I don't know why.
[CUSTOMER][NEUTRAL] EMB was requested EMB attached.
[CUSTOMER][NEUTRAL] Everything matches. Not sure. I'm gonna send this over to the adjuster so that they can review it and reprocess the claim and send a payment out for you. Is there anything else that I can assist you with today?