AccountId: 011433970860
ContactId: 4739b631-2b62-4930-9954-e5855a5eedd2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190130 ms
Total Talk Time (AGENT): 90161 ms
Total Talk Time (CUSTOMER): 59284 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/4739b631-2b62-4930-9954-e5855a5eedd2_20250227T17:53_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, yes ma'am, I need to check on the claim please.
[AGENT][NEUTRAL] OK, I can verify claim status for you and your name is?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and Ms. [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Uh, it is going to be 02462609.
[AGENT][POSITIVE] OK, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And Ms. [PII], verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Uh, it's for [PII] and it's [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Um, [PII] and well the total charge was 6,31744.
[AGENT][NEUTRAL] OK, and the balance after primary?
[CUSTOMER][NEUTRAL] Um, 1,72758.
[AGENT][NEUTRAL] OK, give me one moment. And while I'm looking at claim information, just to let you know we do have an online service center where providers can uh check claim status as well as print out the EOB.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] Uh, this is for Lake Norman Regional Medical Center.
[AGENT][NEUTRAL] OK, I'm showing the claim process is benefits payable only if major medical pays and based on the explanation and benefits received, it does not show that they applied any amounts towards the deductible, co-pay or co-insurance, and that's what we pick up as secondary.
[CUSTOMER][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Alright, so you don't show.
[CUSTOMER][NEUTRAL] Oh, let's see.
[AGENT][NEGATIVE] Yes, ma'am I'm looking at the EOB and it doesn't show the primary has applied anything. Um, looks like they actually denied it. It's not covered, but it doesn't show they applied anything towards deductible, co-pay or co-insurance, and that's what we pick up as secondary.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, is there a claim number?
[AGENT][NEUTRAL] Yes, ma'am. 355-4127.
[CUSTOMER][NEUTRAL] OK, and when did that finalize?
[AGENT][NEUTRAL] Uh, that processed on [PII] of this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Alright and um do you have a reference number or is that just your name or?
[AGENT][NEUTRAL] Uh, you can use my name in today's date if you like.
[CUSTOMER][POSITIVE] OK, alright then I appreciate it thank you.
[AGENT][POSITIVE] Yes, ma'am. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye.