AccountId: 011433970860
ContactId: 3996502e-61a4-4bbc-8e38-a92e5ab213d4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 500399 ms
Total Talk Time (AGENT): 102730 ms
Total Talk Time (CUSTOMER): 139236 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/3996502e-61a4-4bbc-8e38-a92e5ab213d4_20250519T20:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII]. I'm calling from the provider's office. I'm checking for a claim status.
[AGENT][NEUTRAL] OK [PII]. I can help you with claim status. Can you please give me your callback number? You're welcome.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Yeah, sure. My good callback number [PII]. And the uh extension is [PII].
[AGENT][NEUTRAL] OK, thank you. And then may I get the patient's name, date of birth, and policy number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yeah, sure. Before that, can you please spell your name for me for the documentation purpose?
[AGENT][NEUTRAL] Yes, my name is [PII]
[CUSTOMER][NEUTRAL] What was in your name, [PII]?
[AGENT][NEUTRAL] A
[CUSTOMER][NEUTRAL] Yes, thank you. And you said that um uh sorry, you asked for a member's name, right?
[AGENT][NEUTRAL] Name, date of birth, and policy number.
[CUSTOMER][NEUTRAL] So, the member's first name was [PII] and the last name was [PII].
[CUSTOMER][NEUTRAL] [PII] and the date of birth was [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have her policy number?
[CUSTOMER][NEUTRAL] Yeah, I have my policy number. The policy number is 02439226 M as Mike L as Lima 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and then what is the member's data service in charge amount?
[CUSTOMER][NEUTRAL] The rate of service was 27 of 2025. Now, with the total charge amount of $324 even $324.
[AGENT][NEUTRAL] OK, and then what were the charges after the primary paid their part?
[CUSTOMER][NEUTRAL] Uh, just a moment, I will provide you with that. After the primary has paid, uh, the reflecting balance in my and it's $35 even.
[AGENT][POSITIVE] Thank you, sir.
[AGENT][NEUTRAL] 35.
[CUSTOMER][NEUTRAL] And it's showing that the primary has processed the $35 as a co-payment.
[AGENT][NEUTRAL] OK and then can you please give me the facility name you're calling from?
[CUSTOMER][NEUTRAL] Yeah, we're calling from the facility. The facility name was Holy Cross Medical Group.
[AGENT][NEUTRAL] OK [PII] I'm gonna put you on a quick hold while I look up this claim and I'll be right back.
[CUSTOMER][POSITIVE] Sure, take you on time, [PII].
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me. I have the claim information for you, sir.
[AGENT][NEUTRAL] The claim number.
[CUSTOMER][NEUTRAL] Yeah, so what was the claim information?
[AGENT][NEUTRAL] The claim number is 357-533-7. The claim has been denied.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 5337
[AGENT][NEUTRAL] Because office visits are not covered under the patient's plan.
[AGENT][NEUTRAL] And we received the claim on [PII] and processed it.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] Well it's not much.
[CUSTOMER][NEUTRAL] On
[AGENT][NEUTRAL] Yes, we received it on.
[CUSTOMER][NEUTRAL] Yes, and you said that the claim number is 353575337. Uh, the, the, the claim was due to the uh patient according to the patient plan offices are not covered under the patient's plan. Uh, the claim processed on [PII] and uh is that able to get the copy of EOB through the fax?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, what is your fax number, sir?
[CUSTOMER][NEUTRAL] Yeah, so my good fax number, just a moment, please, sir. Yeah, my good fax number, it's going to be [PII].
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] And can you please send it attention to my name, [PII]. My name is spelled [PII]. You shall do my name was [PII].
[AGENT][NEUTRAL] OK, I do. I will get that right to you. I'm gonna put you on a brief hold while I get that ready. I'll be right back, sir.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me. I have that fax on its way to you now.
[CUSTOMER][NEUTRAL] OK. And I know how much time it will take to come get the fax?
[AGENT][NEUTRAL] I've sent it so you just need to give it some time to get there.
[CUSTOMER][POSITIVE] OK. Thank you, thank you so much, [PII]. And can you please provide the call reference for this call?
[AGENT][NEUTRAL] Yes, sir. You can use my name and today's date.
[CUSTOMER][POSITIVE] Uh, thank you, very good to speak with you. Have a nice day. Have a safe day. Bye-bye.
[AGENT][POSITIVE] Bye-bye [PII]. You have a good week and thanks for calling APL.
[CUSTOMER][NEUTRAL] You as