AccountId: 011433970860
ContactId: 3f0d0ed7-b225-4530-8b15-20b7448dae17
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 367040 ms
Total Talk Time (AGENT): 178969 ms
Total Talk Time (CUSTOMER): 87560 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/3f0d0ed7-b225-4530-8b15-20b7448dae17_20250224T17:33_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling on behalf of Saint Francis Hospital, and I'm calling about a claim, um, that, um, we sent y'all, and we, we saw that, um, y'all sent it back but it wasn't paid or anything. It doesn't have any denials on it or anything so I'm just trying to see what's going on with it.
[AGENT][NEUTRAL] OK, [PII], so you have a claim that you're needing to check the status on that was submitted, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] Thank you. And what is your patient's policy number, please?
[CUSTOMER][NEUTRAL] It is 02157443.
[AGENT][NEUTRAL] OK, thank you. So, one moment please while I get the policy information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Pro.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth please?
[CUSTOMER][NEUTRAL] Um, his name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you and what is the date of service and total bill amount?
[CUSTOMER][NEUTRAL] The day of service is 610-2023 and the total bill amount is $4260 even.
[AGENT][POSITIVE] OK, thank you. So give me just one moment.
[AGENT][NEUTRAL] OK, so first off, the policy number that you gave me was not active for the data service. The policy number you provided for me was active, Fiona from [PII]. He has had several other policies, so let me see if there's another policy number that was active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For your data service.
[AGENT][NEUTRAL] And he did not have one so let me see if we just reviewed and processed it under this he did not have an active policy for your data service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me, give me just a moment though to see.
[AGENT][NEUTRAL] 61,020 23 for 4260, is that right?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK. So the claim number.
[AGENT][NEUTRAL] I'm sorry, it's taking just a moment, [PII].
[CUSTOMER][NEUTRAL] Oh, no, no, you're fine, you are fine.
[AGENT][NEUTRAL] OK. So the claim was received and do you have the claim number on the
[CUSTOMER][NEUTRAL] It is with 2872.
[AGENT][NEUTRAL] Information
[AGENT][NEUTRAL] Correct. So, yes, and actually the, the remarks that go along with that should have been on page 2. There should be 2 pages to all of our explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the remark on here stated that
[AGENT][NEGATIVE] The denial remark reads that our records indicate that premium for this data service was not received, therefore benefits are not payable.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Again, there was no policy active with us for this data service.
[AGENT][NEUTRAL] Now I don't know if you've ever been given our portal before [PII], but there we do have a portal that you should be able to also access the explanation of benefits.
[AGENT][NEGATIVE] To get that 2nd page if you need it if you did not receive that.
[AGENT][NEUTRAL] For whatever reason.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is our website for the portal is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] And, um, I'm [PII], um, may I have a claim, I mean not a claim number a call reference number?
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Sure, you will actually use my name along with today's date.
[CUSTOMER][POSITIVE] OK, thank you so much for your help today.
[AGENT][POSITIVE] Well, you are certainly so very welcome. Is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] No ma'am, that'll be all.
[AGENT][POSITIVE] OK, [PII], well then, thank you again for calling ATL and I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Yes, ma'am. Thank you.
[CUSTOMER][POSITIVE] Thank you, bye.
[AGENT][NEUTRAL] Bye-bye.