AccountId: 011433970860
ContactId: 1e7b1e2c-25d5-48f8-8ee5-ba0be99040f7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 462720 ms
Total Talk Time (AGENT): 158412 ms
Total Talk Time (CUSTOMER): 178792 ms
Interruptions: 4
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/1e7b1e2c-25d5-48f8-8ee5-ba0be99040f7_20250416T18:33_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from Deaconess Hospital check on my claim status.
[AGENT][NEUTRAL] OK, did you, I can barely hear you. Could you?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] So, this is [PII] calling from Deaconess Hospital. check on a claim status.
[AGENT][NEUTRAL] OK yeah so you're calling to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, yes, ma'am, I can help you with that. And also, what is a good call back number for you please?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And did you say that the area code was [PII]?
[CUSTOMER][NEUTRAL] And the extension will be
[AGENT][NEUTRAL] Did you say your area code is [PII]?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And your extension?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am, I can help you. And what is that policy number?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] 02558789.
[AGENT][NEUTRAL] OK, thank you one moment while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But the
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and again, any information that is provided would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII] and the last name is [PII] and the date of birth is on [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Ma ma.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Um, the first day of service is on January.
[CUSTOMER][NEUTRAL] [PII] and the total charges will be $6,207 even.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Where do you get a medium.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so we do not have a claim on file for her for this data service for that bill amount. You did say $6,207.00 is that correct?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, and there is no claim on file for that data service for that bill amount.
[CUSTOMER][NEUTRAL] Mm mm, yes.
[CUSTOMER][NEUTRAL] OK. So may I get the effective rate and the term rate for the patient?
[AGENT][NEUTRAL] Policy effective date is going to be.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Term date [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, thank you. So is the mailing address is [PII]?
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Thank you. And what will be the payer ID?
[AGENT][NEUTRAL] 645-56.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK. 645.
[AGENT][NEUTRAL] 56.
[CUSTOMER][NEUTRAL] Mhm. And what will be the time returning limit?
[AGENT][NEUTRAL] No time, no filing limit?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once the claim has been processed, Elsa which you able to check claim status in, and the website for that portal is located at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Not the time limit. That's one year, right?
[AGENT][NEUTRAL] Yes, ma'am. I explained that there is no timely filing limit.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Thank you. So can you move to the next one is for the same patient.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, you had said you have one day of service for one patient. How many days of service do you have?
[CUSTOMER][NEUTRAL] Yes, just one more.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What is the next date of service and total bill amount?
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][NEUTRAL] It's for [PII] and the total charges will be $6,521 even. But it's for the service of 128. Yes, 6521.
[AGENT][NEUTRAL] 65
[AGENT][NEUTRAL] And what was the bill amount? 652-1. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the name of the facility?
[CUSTOMER][NEUTRAL] Deaconess Anderson Hospital.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, and I do not show a claim on file for that bill amount for that data service and again, the policy was not active for that data service.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, do they have any other policy during that data of service?
[AGENT][NEUTRAL] No, ma'am, not with the APL. You would have to reach out to the member to see if they had any other coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you. So may I get the effective, uh sorry, uh call reference number and your name for documentation?
[AGENT][NEUTRAL] My name and today's my name, yes ma'am, my name, I gave you my name and you're gonna use my name along with today's date as your call reference number.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Your name? I didn't get your name.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. Have a great day. Bye-bye. Take care. Happy for the rest of the.
[AGENT][POSITIVE] Oh yeah, yes, ma'am, if that's all I can help you with. I hope you have a nice afternoon too and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.
[CUSTOMER][NEUTRAL] Mm