AccountId: 011433970860
ContactId: 38e42680-7b7f-4b8f-b48d-5d785a3f0344
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211869 ms
Total Talk Time (AGENT): 80059 ms
Total Talk Time (CUSTOMER): 77446 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/38e42680-7b7f-4b8f-b48d-5d785a3f0344_20250213T15:57_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, uh, this is [PII], and I'm calling from Saint Francis Hospital to check on the claim status. Please be informed this call is being monitored and recorded.
[AGENT][NEUTRAL] OK, I can verify the claim status for you. And your name is again [PII]?
[CUSTOMER][POSITIVE] Yes, that is correct. How about yours?
[AGENT][NEUTRAL] It's [PII] last initial [PII], and what is that policy number, please?
[CUSTOMER][NEUTRAL] Thank you, OK. Uh, policy number is 024579992.
[AGENT][NEUTRAL] OK, thank you, one moment. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, call back number is [PII].
[CUSTOMER][NEUTRAL] [PII] direct phone number.
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] That is, that is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. And what was the the data service the amount of the charge?
[CUSTOMER][NEUTRAL] [PII], uh, charge amount?
[AGENT][NEUTRAL] OK, and the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Date of service [PII] amount is $5710 even.
[AGENT][NEUTRAL] And the balance after primary? Oh wait, never mind. One moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] And the name of the provider's office?
[CUSTOMER][NEUTRAL] Saint Francis Hospital.
[AGENT][NEUTRAL] OK, and while I'm looking up claim information, let you know we do have an online service center where providers can check claim status as well as print out the EOB. That site is at [PII].
[CUSTOMER][NEUTRAL] That's noted.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and I'm sure that claim processes, the medical test for this data service is not a covered diagnostic test, therefore benefits are not payable for the claim.
[CUSTOMER][NEUTRAL] OK, noted on that, thank you very much. Uh, may I know if the balance is available to the patient?
[AGENT][NEUTRAL] Uh, we can't give patient responsibility. We can only verify how the claim was processed.
[CUSTOMER][POSITIVE] OK, noted, thank you very much you said that uh.
[CUSTOMER][NEUTRAL] The diagnostic test is not uh covered, is that correct?
[AGENT][NEUTRAL] It's part of the patient's policy that is not a covered diagnostic test, therefore benefits are not covered.
[CUSTOMER][NEUTRAL] That is that the naya.
[CUSTOMER][NEUTRAL] OK, noted, thank you very much for that. So I think that is all for today before I end the call, can I get the call reference?
[AGENT][NEUTRAL] Uh, we don't give reference numbers, you may use my name in today's date.
[CUSTOMER][POSITIVE] OK, noted, thank you very much for that, [PII]. You have a great day. Bye bye. Thank you.
[AGENT][POSITIVE] Alright, you're welcome. Thanks for calling APL. Bye.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Bye bye thank you.
[AGENT][NEUTRAL] Mhm, bye.