AccountId: 011433970860
ContactId: 15195216-8513-4355-870e-1b881049ee8a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218880 ms
Total Talk Time (AGENT): 97420 ms
Total Talk Time (CUSTOMER): 93891 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/15195216-8513-4355-870e-1b881049ee8a_20250109T18:15_UTC.wav
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[AGENT][NEUTRAL] Hi, thanks for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII]. I'm calling from uh Lee Health, and I'm trying to get claim status for a patient.
[AGENT][POSITIVE] Hey, I'd love to help you with claim status today, Ms. [PII], and can I have a good callback number for you?
[CUSTOMER][NEUTRAL] Yes, my direct number is [PII].
[AGENT][POSITIVE] Wonderful. Thank you so much for that. And then, do you mind if I also go ahead and get a good policy number for the patient?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, 226-041-2.
[AGENT][POSITIVE] Wonderful, thank you, thank you, [PII], and let's take a look here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Would you be able to verify for me please your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] This is uh [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Perfect. And are you wanting to get further explanation on the claim you already have a claim number for, or are you needing, um, need to search for the claim for you?
[CUSTOMER][NEUTRAL] I need it to be searched for because um I I guess it was just billed on the [PII] so I was wondering if it went to the right place. I also need to check if you guys use like a PPO network.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, yeah, um, what was the date of service on the claim you want to look at?
[CUSTOMER][NEUTRAL] This was [PII].
[CUSTOMER][NEUTRAL] And let's see if I can get the charge amount right when you're ready.
[AGENT][NEUTRAL] That's
[AGENT][NEUTRAL] Yes, I am.
[CUSTOMER][NEUTRAL] It is $7370 even.
[AGENT][NEUTRAL] Perfect and you said 52,020 24, correct?
[CUSTOMER][POSITIVE] That is correct, yes.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And what was the
[AGENT][NEUTRAL] Name of the company for that claim?
[CUSTOMER][NEUTRAL] Um, it was Lee Memorial Health System. It could be outpatient center.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Perfect. So it looks like your claim was received on the [PII], um, and it is in Q2 be processed but it has not yet been processed and then as.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, I just arrived yesterday.
[AGENT][NEUTRAL] Far as the
[AGENT][NEUTRAL] Um, network, what we do is we follow their major medical as their secondary, um, so whatever network their major medical is in is what we follow.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So as long as the patients in network like their primary is Aetna, so as long as um the, the providers uh par with Aetna, you would also um consider it as a network.
[AGENT][POSITIVE] Yes, absolutely.
[CUSTOMER][NEUTRAL] Perfect. OK, is there a claim number um assigned to it yet?
[AGENT][NEUTRAL] No, I'm sorry.
[CUSTOMER][NEUTRAL] That's OK. I just wanted to check and about how long is typically the turnaround time?
[AGENT][NEUTRAL] They say 7 to 10 business days.
[CUSTOMER][POSITIVE] Oh wow, that's pretty quick. OK, perfect and then um I think that is all I have. [PII], can I just have the first letter to your last name and a reference number if you don't mind?
[AGENT][NEUTRAL] Yeah, you betcha. The first letter to my last name is B like boy, and then the reference number is just my name Ali B and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Excellent well I hope you have a great um upcoming weekend. Thank you for your help.
[AGENT][POSITIVE] Hey, my pleasure you too, Miss [PII], take care and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye bye.