AccountId: 011433970860
ContactId: 48c3d357-50ff-47a6-b81a-c677cb68da34
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 317660 ms
Total Talk Time (AGENT): 81816 ms
Total Talk Time (CUSTOMER): 68659 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/48c3d357-50ff-47a6-b81a-c677cb68da34_20250407T17:34_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good afternoon, [PII]. My name is [PII]. I'm calling from uh Mercy Fitzgerald Hospital, and I'm calling to see if I can get some assistance with the denied claim.
[AGENT][NEUTRAL] OK, I can help you with the claim, Miss [PII]. Can I please get your call number ma'am just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Sure. That's [PII] and that's my direct number.
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] 02284617 A for apple, M for Mary, L for Lima 8.
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[AGENT][NEUTRAL] OK, and then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] 120 2025 for 195.
[AGENT][NEUTRAL] OK, and what's the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Oh, that's
[CUSTOMER][NEUTRAL] $25.
[AGENT][NEUTRAL] $25. OK, I'm gonna put you on a quick hold, Ms. [PII], while I pull up this claim and I'll be right back, ma'am.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Ah.
[AGENT][NEUTRAL] Ms. [PII], you had mentioned that the claim was denied. Can you please give me that claim number?
[CUSTOMER][NEUTRAL] Sure. That's.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I have 357-6774.
[AGENT][NEUTRAL] OK. All right, brief hold again. I'll be right back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you for holding for me, Ms. [PII]. Would that claim be under another name?
[CUSTOMER][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Because I've got that claim pulled up the number that you gave me, but it's not for the same provider name that you gave me at the beginning of the call.
[CUSTOMER][NEUTRAL] Um, it could be on the Trinity Health Mid-Atlantic Medical Group.
[AGENT][NEUTRAL] Yes ma'am, that's correct. Um, the claim was denied because office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] OK, so this is patient responsibility.
[CUSTOMER][NEUTRAL] OK, perfect. May I please have the initials of your last name and a reference for the call?
[AGENT][NEUTRAL] Yes, ma'am. Um, you can use my name, [PII] The last initial is [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Have a wonderful day.
[AGENT][POSITIVE] You too, Ms. [PII]. Thanks for calling [PII]. I hope you have a good day also.
[AGENT][NEUTRAL] Bye-bye, ma'am.
[CUSTOMER][POSITIVE] Thank you.