AccountId: 011433970860
ContactId: 3b5853b7-f979-406d-9987-03c4d5a2a7cf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 454980 ms
Total Talk Time (AGENT): 129239 ms
Total Talk Time (CUSTOMER): 144005 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/3b5853b7-f979-406d-9987-03c4d5a2a7cf_20250402T12:47_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey Ms. [PII], how are you doing? This is [PII]. I have, I'm sorry, go ahead. I asked you a question. I have a
[AGENT][NEGATIVE] I'm getting hurt
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I have a provider on the line named [PII]. She's calling about a policy that I've never saw before.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, what's the policy number?
[CUSTOMER][NEUTRAL] 253-380-1
[AGENT][NEUTRAL] OK, let me pull that up.
[AGENT][NEUTRAL] Is she wanting benefits?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, you can send her through if you want to.
[CUSTOMER][NEUTRAL] OK, thank you, Ms. [PII]. Hold one moment.
[AGENT][NEUTRAL] You're welcome, [PII]. OK.
[CUSTOMER][POSITIVE] Hey hello Miss. [PII]. I'm gonna transfer you over to Miss [PII]. She's gonna assist you better. Thanks for calling. Have a great day. You're welcome. You too bye.
[AGENT][NEUTRAL] Hi, this is [PII]. Um, how can I help you, ma'am?
[CUSTOMER][NEUTRAL] Um, yes ma'am, I was calling to see, uh, a patient of ours had a procedure here, did not let us know if he had y'all as I guess like a secondary insurance until just recently, and I was trying to find out if there was coverage for this patient and if so, get the billing information all that so I can send the uh claim over to y'all.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and is your name [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, and verify the patient's name and date of birth for me please.
[CUSTOMER][NEUTRAL] Uh, [PII], last name is [PII] [PII] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And so I'm showing an effective date of [PII], the policy is active. What type of service is it for?
[CUSTOMER][NEUTRAL] Um, it looks like he had, let me double check what he had done.
[CUSTOMER][NEUTRAL] He had a good grief, what the heck is this?
[CUSTOMER][NEUTRAL] Oh, it looks like he had a placement or a device for to do his radiation therapy for his prostate cancer.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what type of service did you say he's doing today?
[CUSTOMER][NEGATIVE] He had it already done on [PII] and then we sent him a bill for the balance and that's when he told us he had y'all as well as Blue Cross Blue Shield who we billed.
[AGENT][NEUTRAL] OK. Yeah.
[AGENT][NEUTRAL] Right, and
[AGENT][NEUTRAL] Alright, tell me again what type of service it was did you say testing?
[CUSTOMER][NEUTRAL] Um, it was, uh, no, it was a, excuse me, sorry, my allergies are really bad today.
[AGENT][NEUTRAL] Understand.
[CUSTOMER][NEUTRAL] He had a placement of a radiation device implanted in him for his cancer.
[AGENT][NEUTRAL] Radiation device.
[AGENT][NEUTRAL] What is that? Is that pump radiation periodically?
[CUSTOMER][NEGATIVE] I guess so. I do not. I would be lying to you if I told you that.
[AGENT][NEUTRAL] I've not heard of that before.
[AGENT][NEUTRAL] OK, what's a good phone number, [PII], in case we're just
[CUSTOMER][NEUTRAL] Yeah, so place would have been OK, it's [PII].
[AGENT][NEUTRAL] Give me one moment I'm gonna need to look at his policy.
[CUSTOMER][POSITIVE] No problem, I'm looking it up online too.
[AGENT][NEUTRAL] Yeah, I've not heard of a medi uh radiation device that's implanted.
[CUSTOMER][NEUTRAL] Place, yeah, it says uh placement of an interversal device for radiation therapy guidance. OK, so it's for guidance in the prostate.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I'm gonna review the policy um you can still go ahead and submit the claim for review and um based on the coding on the claim we could verify, can you hold for a quick moment?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes ma'am. You are on hold.
[AGENT][NEUTRAL] Hey, Ms. [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm
[AGENT][NEUTRAL] Can you hear me, [PII]?
[CUSTOMER][POSITIVE] I can now yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] It sounds like my phone is muted to me.
[CUSTOMER][NEUTRAL] Oh, that's
[AGENT][NEUTRAL] So I was just checking. 1 2nd.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, so I'm looking at the wording in the policy. I'm gonna just suggest that you go ahead and submit the claim over to us, [PII], um, of course you know I can't guarantee, uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Anything until we get the actual document to look at the coding and everything?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And if you could do that and we can take a look at it.
[CUSTOMER][NEUTRAL] OK, can I get the uh address please?
[AGENT][NEUTRAL] Uh, it's [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, let's see
[CUSTOMER][NEUTRAL] OK, what is the zip again? [PII]?
[AGENT][NEUTRAL] Uh-huh [PII].
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Alright, and do you is there a electronic payer ID number for y'all or do claims go to y'all directly by paper?
[AGENT][NEUTRAL] Mhm, 60801.
[CUSTOMER][POSITIVE] All right, well, I greatly appreciate it thank you so much for your help today.
[AGENT][POSITIVE] Then you're welcome. And if no other questions, [PII], thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.