AccountId: 011433970860
ContactId: 3a33641c-a8e1-4691-9c3c-24caa24af9e3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 460339 ms
Total Talk Time (AGENT): 95399 ms
Total Talk Time (CUSTOMER): 112926 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/3a33641c-a8e1-4691-9c3c-24caa24af9e3_20250417T13:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] from Coastal Carolina Medical Center to check for claim status for or for claim underpayment for training and quality purposes, this call is being recorded.
[AGENT][NEUTRAL] OK, [PII], do you have the policy number?
[CUSTOMER][NEUTRAL] I do have policy ID.
[CUSTOMER][NEUTRAL] 02365128.
[AGENT][POSITIVE] OK, perfect, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and then what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] That is [PII]. That's the same direct?
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK. And then what's the patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] This is for the [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then do you have a data service and a charge amount?
[CUSTOMER][NEUTRAL] Yes, date of birth is [PII]. Billed amount of $3,679.
[AGENT][NEUTRAL] OK, you said [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And charge amount $50,679.
[CUSTOMER][NEUTRAL] 53,679.
[AGENT][POSITIVE] OK, perfect. Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Sorry, just one moment.
[AGENT][NEUTRAL] OK, just a minute. I think I found this claim you're looking for.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so it looks like for the amount $5,369 was denied because outpatient benefits for this calendar year has been met.
[CUSTOMER][NEUTRAL] OK, good. So the remaining uh since our team is still underpaid, only received the payment of $5000. That's not available to the patient.
[AGENT][NEUTRAL] Yes, the $5,369 was denied. Yes, because outpatient benefits for this calendar year has been met and we do not determine patients responsibility. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I see. So if, uh, sorry, because, um, actually the $5700 here is that payment it's
[CUSTOMER][NEUTRAL] The payments under pay so we're still, uh, short of $96.71. So I mentioned uh you cannot provide any uh if the remaining balance is available to the patient. So is it possible that we can or appeal for this one.
[AGENT][NEGATIVE] Sorry, your phone is breaking up.
[CUSTOMER][NEUTRAL] Um, can you please submit dispute is still under bid?
[AGENT][NEGATIVE] Sorry, um, [PII], your phone is breaking up. I can barely hear you.
[CUSTOMER][NEUTRAL] Uh, one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you hear me clearly?
[AGENT][NEUTRAL] Uh, not really. It's really choppy.
[AGENT][NEUTRAL] Do you mind if I give you a call back? Maybe that would fix it?
[CUSTOMER][NEUTRAL] Um, yes.
[AGENT][NEUTRAL] OK, the phone number I have is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yes direct line.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, I will give you a call back, OK?
[AGENT][NEUTRAL] OK, goodbye.