AccountId: 011433970860
ContactId: 229d28b3-0d9a-4493-9e06-3b47e71c77e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 589659 ms
Total Talk Time (AGENT): 160529 ms
Total Talk Time (CUSTOMER): 165341 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/229d28b3-0d9a-4493-9e06-3b47e71c77e8_20250328T20:56_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so this is [PII] calling from Mercy clinic looking for a claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, Mr. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, can you give me the middle numbers one more time? I got [PII]. What's the middle numbers?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, and I got the extension. Thank you. All right. And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Mercy Clinic.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Which is policy number I have 02462881.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Mm yeah actually I have multiple claims for this page and I try to get the claim status in the portal. I don't see a claim of those claims. Uh, first data service I have [PII] and the bill amount $184 even.
[AGENT][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Of [PII], you said [PII] is the date of service?
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's for [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] So this one is um denied stating that office visits are not covered by the policy.
[AGENT][NEUTRAL] And it was processed on, let's see.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, may I have the claim number?
[AGENT][NEUTRAL] Mhm. The claim number is um.
[AGENT][NEUTRAL] 3532512.
[CUSTOMER][NEUTRAL] 353.
[AGENT][NEUTRAL] 3532512.
[CUSTOMER][NEUTRAL] 12.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You.
[CUSTOMER][NEUTRAL] And you have the patient's name is [PII], is it correct?
[AGENT][NEUTRAL] Mhm. Yes.
[CUSTOMER][NEUTRAL] Because I'm trying to get those, uh, you know, clients in the portal but I don't.
[CUSTOMER][NEUTRAL] Yeah, when I came to the client number I'm able to.
[CUSTOMER][NEUTRAL] For the decline.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] No, uh, actually I tried to get the claim information in this portal, but I don't find a client because I have multiple clients for the same patient. When I enter the claim number, I'm able to get the claim. If you don't mind, is it possible to get a claim number for the many clients?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I can get the UOB from the portal.
[AGENT][NEUTRAL] Yes, how many?
[AGENT][NEUTRAL] How many claims do you have?
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Uh, for the station I have 5 clients, 4 more clients.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] For cleans, mhm. OK. uh, and what is the next one?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Next one, data services [PII].
[CUSTOMER][NEUTRAL] And the bill amount $328 even.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] Sorry, you said [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] 23. OK, bear with me just a second.
[AGENT][NEUTRAL] Mm you said how much is it for?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, it's a $328 328.
[AGENT][NEUTRAL] 328. OK.
[CUSTOMER][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] OK, that one was also denied and that claim is 344.
[AGENT][NEUTRAL] 671 9.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Next date of service.
[CUSTOMER][NEUTRAL] [PII] and the bill amount $184.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] OK. This was denied stating office visits are not covered.
[AGENT][NEUTRAL] And this one is claim number 3532514.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The next one data service.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the bill amount I have.
[CUSTOMER][NEUTRAL] $557 even.
[AGENT][NEUTRAL] OK, you said 5009.
[AGENT][NEUTRAL] What's the procedure code on that one?
[CUSTOMER][NEUTRAL] 43238
[AGENT][NEUTRAL] OK, so this one that one was paid, processing paid. The claim number is 3509125.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] and
[CUSTOMER][NEUTRAL] The last client data service again this one house.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] I'll just phone please I Mr.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I'm very sorry, this plan for data service [PII].
[CUSTOMER][NEUTRAL] And the bill amount $184.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's for a different provider.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] So [PII].
[AGENT][NEUTRAL] You said it's a different provider?
[CUSTOMER][NEUTRAL] Yes, 54.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Kon.
[AGENT][NEGATIVE] It looks like they were both denied as office visits are not covered.
[CUSTOMER][POSITIVE] Good
[AGENT][NEUTRAL] And um this one is claim number 3515949.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, that's not for you. Thank you so much for your time and patience. So have a wonderful day. Bye.
[AGENT][POSITIVE] You're welcome. You as well. Thank you for calling API. Bye-bye, Mr.