AccountId: 011433970860
ContactId: 31ead95d-adff-4a27-9cbf-9a9532a29655
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 584000 ms
Total Talk Time (AGENT): 147117 ms
Total Talk Time (CUSTOMER): 94751 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/31ead95d-adff-4a27-9cbf-9a9532a29655_20250311T20:28_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] from provider's office to check a claim status.
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Yeah, it is, it's going to be.
[CUSTOMER][NEUTRAL] 02138119.
[AGENT][NEUTRAL] 021-881-19.
[CUSTOMER][NEUTRAL] No, 021-38119.
[AGENT][NEUTRAL] 381.
[AGENT][NEUTRAL] 19 OK and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] That is [PII]. Extension [PII] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Hey you there?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What's happened?
[AGENT][NEUTRAL] I'm trying to pull up this file. Give me a second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And my system is wanting to do its own thing.
[AGENT][NEUTRAL] OK, I think I have it. What's the patient's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] Patient first name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] All right, and you said that you're checking claim status, right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And if you could verify the date of service and the total charge.
[CUSTOMER][NEUTRAL] Yeah, it is [PII] for $370 even. And I couldn't catch your name. What did you say your name?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yeah, I got it.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] You're not
[AGENT][NEUTRAL] See
[AGENT][NEUTRAL] I'm not showing [PII] for this patient.
[CUSTOMER][NEUTRAL] So, can you verify member's eligibility for me?
[AGENT][NEUTRAL] Uh-huh. Effective [PII], term [PII], verify the patient's date of birth for me again.
[CUSTOMER][NEUTRAL] Yeah, sure, it is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm gonna look one more time.
[AGENT][NEUTRAL] OK, I was actually looking under the wrong dependent. I see it here. Um, is it a hospital charge or a facility charge?
[CUSTOMER][NEUTRAL] Facility charge.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the name of the facility?
[CUSTOMER][NEUTRAL] Yeah, it is Mersey East Ambulatory Service.
[AGENT][NEUTRAL] OK, received on [PII], processed [PII].
[AGENT][NEUTRAL] There was no payment made on this claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm showing that.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] So it looks like the 9254 was applied towards the calendar year deductible under this policy.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Pay nothing but allowed 92.54% as a deductible, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, may I have a claim number on this one?
[AGENT][NEUTRAL] Uh-huh. That number is 340-8100.
[CUSTOMER][NEUTRAL] That is 3,408,100, right?
[AGENT][NEUTRAL] And you get
[AGENT][NEUTRAL] Uh-huh, and you can also check status online at the keyword.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. And also, I want a copy of the UB so could you fax it to me?
[AGENT][NEUTRAL] Um, it was already mailed, uh, when the claim was processed, [PII], so it is now available online. I can assist you with downloading it from the website if you would like.
[CUSTOMER][NEUTRAL] OK, no problem. And may I have a reference number for this and also I just want to know what is the member's annual deductible.
[AGENT][NEGATIVE] It's $1000 for hell of a year.
[CUSTOMER][NEUTRAL] Uh, OK. And how much member during the date of service?
[AGENT][NEUTRAL] Of that claim, uh, $92 and.
[AGENT][NEUTRAL] 54 cents was applied.
[AGENT][NEUTRAL] 9254.
[CUSTOMER][NEUTRAL] That was the uh accumulated right during the the services.
[AGENT][NEUTRAL] You ask how much was applied to to your claim. We apply $92.54 to the claim under towards the deductible.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, no, no. I, I, I, I asked you how much member met during the date of service.
[AGENT][NEUTRAL] During the date of service, how much of the deductible is met?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yup.
[AGENT][NEUTRAL] 9254.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you. May I have a reference number for this call?
[AGENT][NEUTRAL] Again, it's my name and today's date, [PII], first initial last name is [PII] Any other questions?
[CUSTOMER][POSITIVE] No, [PII]. Thank you. Thank you so much for your assistance. Have a nice day. Bye for now.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Have a good day.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.