AccountId: 011433970860
ContactId: 39e70476-6627-4381-aa74-1daeaa29b43d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 330720 ms
Total Talk Time (AGENT): 80643 ms
Total Talk Time (CUSTOMER): 98226 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/39e70476-6627-4381-aa74-1daeaa29b43d_20250331T17:52_UTC.wav
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[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII]. I am calling from Progress West Healthcare, and I was trying to check the status of a medical claim we submitted for a patient.
[AGENT][NEUTRAL] Yeah, this is [PII]. How may I?
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with the claim. Can you give me the name of your facility one more time, please?
[CUSTOMER][NEUTRAL] Sure, Progress West Healthcare.
[AGENT][NEUTRAL] Progress West. OK, thank you and what's your callback number, Ms. [PII] in case our call gets disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK, and then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII] and [PII], [PII].
[CUSTOMER][NEUTRAL] And policy number is 12 excuse me, 1828789.
[AGENT][NEUTRAL] OK, let me look that policy up real quick.
[AGENT][NEUTRAL] OK, and then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] Data service is [PII].
[CUSTOMER][NEUTRAL] And we bill $1,658.25.
[AGENT][NEUTRAL] OK, and then what's the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] It's the thing, let me see why they primary didn't pay.
[CUSTOMER][NEUTRAL] Um, the primary didn't pay and stated it was the $1,658.25 was the deductible amount.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on a quick hold while I look up this claim and I'll be right back.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you, Ms. [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, Ms. [PII]. So looking on data service of [PII], I do not find a claim on file for [PII] for that date of service.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Is the correct claim address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, ma'am, that's not the right address. Let me give you the right address.
[CUSTOMER][POSITIVE] OK. Yes, ma'am, I'm ready.
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] It's [PII] and that's [PII].
[AGENT][NEUTRAL] That's in [PII].
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] I bite you.
[CUSTOMER][POSITIVE] And I'm so sorry, I missed your name at the beginning of the call.
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][POSITIVE] Got it. [PII], thank you so much for looking into this and providing the information. Um, I'll go ahead and resubmit the claim today.
[AGENT][NEUTRAL] OK. All right, Ms. [PII], can I help you with anything else before we go?
[CUSTOMER][POSITIVE] Oh, no, ma'am, that's all I have for now, but thank you again so much.
[AGENT][POSITIVE] You're welcome and you have a wonderful week and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you. You do the same. Mm bye.
[AGENT][NEUTRAL] Bye-bye, ma'am.