AccountId: 011433970860
ContactId: 19944c91-4d48-457f-b3b2-1a923c0e8fd9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 909429 ms
Total Talk Time (AGENT): 172408 ms
Total Talk Time (CUSTOMER): 420836 ms
Interruptions: 11
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/19944c91-4d48-457f-b3b2-1a923c0e8fd9_20250414T14:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Thank you. Uh, hi, [PII]. This is [PII] calling from the provider's office, and I'm looking for the claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status, and you said your name was [PII]?
[CUSTOMER][NEUTRAL] OK, I can help you with claim status. And you said your name was [PII] Last name [PII]. [PII]. Yeah.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] OK. Thank you, sir.
[CUSTOMER][POSITIVE] OK. Thank you, sir.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], can you please give me your callback number just in case our call is disconnected? Sure. That one is [PII]. Direct line.
[AGENT][POSITIVE] Thanks.
[AGENT][NEUTRAL] Thank you sir and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Thank you, sir. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Uh so patient's first name is [PII]. It's [PII], and the last name is [PII]'s uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you very much. And then what is [PII]'s policy number?
[CUSTOMER][NEUTRAL] OK, thank you very much. And then what is [PII]'s policy number?
[CUSTOMER][NEUTRAL] Policy number, just a moment.
[AGENT][POSITIVE] Yes sir, take your time.
[CUSTOMER][POSITIVE] Yes, sir. Take your time. Oh yeah, I have got it. And the number is 1896483.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] OK. All right. Let me look that up real quick.
[CUSTOMER][NEUTRAL] OK. All right, let me look that up real quick. Yeah.
[AGENT][NEUTRAL] OK, I've got her pulled up and can you please give me the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Could you please give me the date of service and the charge amount. Sure, just a moment.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] Yeah, that one is [PII].
[AGENT][NEUTRAL] Thank you. And then the charge amount for the data service?
[CUSTOMER][NEUTRAL] Uh, yeah, the total charge is $1,7045 even. It's a 1705.
[AGENT][NEUTRAL] OK, and then what are the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] The charges after the primary insurance paid their part.
[CUSTOMER][NEUTRAL] OK. So the lifter balance is $859.92.
[AGENT][POSITIVE] Thank you. I appreciate you. Uh-huh. Go ahead.
[CUSTOMER][NEUTRAL] Actually, uh, this is, yeah, just a moment, just, just one thing I wanted to inform, uh, that UC has processed the claim and the liter balance 859.92 is left.
[CUSTOMER][NEUTRAL] And this is a crossword claim.
[AGENT][NEUTRAL] OK, alright, thank you, and then may I please have the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, that one is uh Memorial Lawn Catering Cancer Center. Short form is MSKCC.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, [PII] while I look up this claim for you and I will be right back sir.
[CUSTOMER][NEUTRAL] I'll put you on a brief hold, [PII], while I look up this claim for you and I will be right back, sir. All right, thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], this is [PII] back with you again. So looking on data service of [PII].
[CUSTOMER][NEUTRAL] You again, so looking on data service of [PII]. Mhm.
[AGENT][NEUTRAL] I do not find a claim on file as the policy terminated.
[CUSTOMER][NEUTRAL] I do not find a claim on file as the policy terminated.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] Uh, policy terminated on?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh, would you please repeat uh the date again?
[AGENT][NEUTRAL] Yes, the policy terminated on [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, the policy terminated on [PII]. [PII]. OK. Uh, but, uh, whether you have already received the claim, would you please confirm?
[AGENT][NEUTRAL] No, there's no claim on file.
[CUSTOMER][NEUTRAL] No, there's no claim on file.
[CUSTOMER][NEUTRAL] Uh, actually, from our side, this, it is so, it seems to be claim was, uh, claim was billed to you already. And from your side on [PII], uh, it was processed but uh because of we are not having any UP therefore, we are unable to identify. But as per system, it is mentioned on August, sorry, [PII], it is uh denied from your side.
[AGENT][NEUTRAL] OK, do you have a claim number?
[CUSTOMER][NEUTRAL] OK, do you have a claim number? Uh, no, no, for the claim number itself, I just want to uh we we have given a call because of the claim number because we just need to have the proof therefore.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] For the amount that you gave me I.
[CUSTOMER][NEUTRAL] Um, I, I'll confirm you one thing again, um that you gave me. Yeah, please go on.
[AGENT][NEUTRAL] I do, I do not show a claim on file.
[CUSTOMER][NEUTRAL] I do, I do not show a claim on file.
[CUSTOMER][NEUTRAL] Uh, so would you please check, uh, from the bill amount?
[CUSTOMER][NEUTRAL] 1705.00.
[AGENT][NEUTRAL] That that amount is not on file.
[CUSTOMER][NEUTRAL] That that amount is not on file. Neither is 85992.
[AGENT][NEUTRAL] And neither is the 85992.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Uh, there are two different amounts. Uh those are showing, uh, as, uh, left out. So, first amount is under deductible amount. Uh, it's, it's a 799.92. This is uh kept as a deductible and another amount is $60 even that is kept as a co-pay.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So, um, addition of both, it's consisting, it's uh 859.92, therefore.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right. So there's the amount that I was looking. Yes, sir, and I have the claim pulled out.
[CUSTOMER][NEUTRAL] So would you be to take that one? OK. All right, there's the amount that I was. Yes, sir. And I have the claim pulled up. OK, OK, OK. So I just, I, I, I would have been informed you earlier this thing, this bifurcation. I'm so sorry for that.
[AGENT][NEUTRAL] That's OK. That's OK.
[CUSTOMER][NEUTRAL] Going forward, I'll just keep it in mind.
[AGENT][NEUTRAL] Yes, sir. I understand.
[CUSTOMER][NEUTRAL] That's OK, OK.
[AGENT][NEUTRAL] We found it
[CUSTOMER][NEUTRAL] Yes sir, I understand.
[CUSTOMER][NEUTRAL] We found it. OK.
[AGENT][NEUTRAL] OK, so the claim number is 351.
[CUSTOMER][NEUTRAL] OK, so the claim number is 351. OK.
[AGENT][NEUTRAL] 2341.
[CUSTOMER][NEUTRAL] 2341?
[CUSTOMER][NEUTRAL] 2341. All right. And would you please confirm when the claim is received and uh processed date.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Let me look real quick.
[CUSTOMER][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] Look real quick.
[AGENT][NEUTRAL] We received it on [PII].
[CUSTOMER][NEUTRAL] We received it on [PII]. Mhm.
[AGENT][NEUTRAL] And processed it on [PII].
[CUSTOMER][NEUTRAL] [PII], yeah.
[CUSTOMER][NEUTRAL] And process it on [PII].
[CUSTOMER][NEUTRAL] All right. And uh process means uh any payment has been made from your side?
[AGENT][NEUTRAL] No, it was denied on [PII].
[CUSTOMER][NEUTRAL] Status.
[CUSTOMER][NEUTRAL] No, it was denied on [PII].
[AGENT][NEUTRAL] Services were rendered after policy termination date.
[CUSTOMER][NEUTRAL] I need to rendered after policy termination date.
[CUSTOMER][NEUTRAL] Oh, as already you have confirmed this one. on [PII], the policy was terminated.
[CUSTOMER][NEUTRAL] Yeah, OK. Uh, so would, would you please confirm, uh, would you please send us an UV of the claim?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, can I get your fax number?
[CUSTOMER][NEUTRAL] OK so we just need to add as a as a proof. Can I get your fax number? Sure. I'll just confirm you that so just a moment.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah. So that one is [PII].
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you. All right, [PII], I'm gonna put you on a brief hold while I get this fax ready for you and I'll be right back.
[CUSTOMER][NEUTRAL] OK thanks hold up here I put you on a brief hold while I get this fax ready for you and I'll be right back. Sure, sure, you can mention, uh, my name [PII] as intention.
[AGENT][POSITIVE] OK, I will do that for you.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] OK, I will do that for you. Sure. Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I'll be with. You are on hold.
[AGENT][NEUTRAL] To.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Come on.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me [PII]. I have that fax on its way to you now.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Thank you for holding for me, [PII]. I have that it's way to you now. All right. Thank you so much. And uh uh how much time it will be taking you to reach out? 22, half an hour?
[AGENT][NEUTRAL] Uh, maybe 10 minutes. Uh, I sent it and it's going through the process.
[CUSTOMER][NEUTRAL] Uh, maybe 10 minutes. Uh, I sent it and it's going through the process.
[CUSTOMER][NEUTRAL] All right. All right. Thank you so much. And uh uh would you please confirm me the, the claim, uh sorry, the reference number?
[AGENT][NEUTRAL] Yes sir, you can use my name [PII]
[CUSTOMER][NEUTRAL] Yes sir, you can use my name [PII]
[AGENT][NEUTRAL] In today's date.
[CUSTOMER][NEUTRAL] Uh, initial of your last name, please.
[AGENT][NEUTRAL] A
[CUSTOMER][NEUTRAL] All right. Uh, would you please confirm your initial of your last name, please? All right.
[CUSTOMER][POSITIVE] So, thank you so much, [PII], for providing this detail and proding your valuable time. Have a great day. Bye.
[AGENT][POSITIVE] You're very welcome, [PII]. Bye-bye. You have a wonderful day too. Thank you for calling APL.
[CUSTOMER][POSITIVE] You're very welcome, [PII] bye bye and you have a wonderful day too. Thank you for calling APL. Bye.