AccountId: 011433970860
ContactId: 248adfb4-d774-4462-a0c7-c2ec15e0b25f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 678700 ms
Total Talk Time (AGENT): 131422 ms
Total Talk Time (CUSTOMER): 296068 ms
Interruptions: 5
Overall Sentiment: AGENT=1.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/248adfb4-d774-4462-a0c7-c2ec15e0b25f_20250408T17:32_UTC.wav
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[AGENT][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Hello, I'm I audible?
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, this is [PII] APL.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider office looking for the general claim status.
[CUSTOMER][NEUTRAL] What you know what.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can help you with claim status. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Yeah, I better spell out my name. That is [PII].
[CUSTOMER][NEUTRAL] And my callback number is
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And can you spell you?
[AGENT][NEUTRAL] Uh, yes, my name is [PII]. It's [PII]
[CUSTOMER][POSITIVE] Thank you very much.
[CUSTOMER][NEUTRAL] OK, sorry, can you help me with the status of a claim?
[AGENT][NEUTRAL] Uh yes sir, I can help you with the claim. I'm gonna put you on a brief hold for a minute. I'll be right back with you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, thank you very much for holding for me. Um, can, I can help you with the claim status. Can I please get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Let's start with the policy number.
[CUSTOMER][NEUTRAL] That is.
[CUSTOMER][NEUTRAL] Uh, that is alphanumeric, starting with the letter R as in Romeo, S as in Sam, P as in Papa, 1.
[CUSTOMER][NEUTRAL] Then 4 consecutive 045.
[AGENT][NEUTRAL] OK, and that is not one of our policy numbers?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, do you see another number?
[CUSTOMER][NEGATIVE] Uh, no.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, do you see a social?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Wait, wait, uh, can you pull out the patient through social security number?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Let me provide you the accession of this member. Just, just a moment. Let me pull out that information.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I just.
[CUSTOMER][NEUTRAL] And the social security number.
[CUSTOMER][NEUTRAL] uh
[CUSTOMER][NEGATIVE] Sorry, just a moment. My system is lagging.
[CUSTOMER][NEUTRAL] OK, uh, so it's just.
[CUSTOMER][NEUTRAL] Uh, yes, uh, you're ready for that?
[AGENT][NEUTRAL] Yes, I am.
[CUSTOMER][NEUTRAL] OK. The SSN is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's
[AGENT][NEUTRAL] OK, and what is the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Uh, member is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you so much and let me pull that in real.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][POSITIVE] Yeah, thank you.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, I've got the policy trying to pull in now.
[CUSTOMER][NEUTRAL] Mhm. So, can you provide me the policy details like member insured ID?
[AGENT][NEUTRAL] Yes, the policy number is 1375494.
[CUSTOMER][NEUTRAL] 1375494, correct?
[AGENT][NEUTRAL] Yes, that's correct. OK, and can you give me the date of service of the claim?
[CUSTOMER][NEUTRAL] And what
[CUSTOMER][NEUTRAL] Uh yes, I can. That is [PII].
[AGENT][NEUTRAL] OK, and what is the charge amount?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The total charges is $1,791.20.
[AGENT][NEUTRAL] OK, and then what's the charges after the primary insurance?
[CUSTOMER][NEUTRAL] Ma
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh yes.
[CUSTOMER][NEUTRAL] Uh, just a moment, I will look at that for you.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEGATIVE] My system is very slow. Uh, yeah, I'm there. Actually, my system is very slow. I don't know what it's going, so just, just a moment.
[AGENT][NEUTRAL] Are you there?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, mine has been crazy today too. Take your time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thanks a lot for waiting.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] you gonna
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] M
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][NEUTRAL] OK, OK, uh, now it is OK, and let me see, and the primary is the primary insurance is Blue Cross of Mississippi.
[CUSTOMER][NEUTRAL] And you will be.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] The.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] Mm mm mm mm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, actually, Tory, I don't found the primary insurance OB.
[AGENT][NEUTRAL] OK, I will try to look it up. I'll try to look it up with the information that you gave me, uh, see if we can pull it in that way. What is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] So, let me double check.
[CUSTOMER][NEUTRAL] Do.
[CUSTOMER][NEUTRAL] Uh, that is, uh, wait, uh.
[CUSTOMER][NEUTRAL] Claiborne County Hospitals.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim and I'll be right back sir.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, take your time to. You are on hold.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] 1124.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, [PII], thank you very much for holding for me. So looking on data service of [PII], there's no claim on file. The policy.
[AGENT][NEUTRAL] Terminated on [PII] and there are no active policies on file at this time.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] people
[CUSTOMER][NEUTRAL] OK, the policy terminated on [PII] and after that, you don't have any information for the next policy on that, right?
[AGENT][NEUTRAL] Correct. For that date of service, no, sir.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, I got you and.
[CUSTOMER][NEUTRAL] Can I have this call reference number?
[AGENT][NEUTRAL] Yes sir, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you very much, sorry, for your time and for the information as well. Have a nice day.
[AGENT][NEUTRAL] You too, [PII], is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] No, that will be all. Thanks for asking.
[AGENT][POSITIVE] Thank you for calling APL you have.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Yeah.