AccountId: 011433970860
ContactId: 494ddc19-072d-419f-9c7e-dbef0dfe2e47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 487500 ms
Total Talk Time (AGENT): 119885 ms
Total Talk Time (CUSTOMER): 184667 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/494ddc19-072d-419f-9c7e-dbef0dfe2e47_20250523T20:38_UTC.wav
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[AGENT][POSITIVE] Thank you for calling this is.
[CUSTOMER][NEUTRAL] Uh yes, my first name is [PII], my last name is [PII] calling you from the provider's office looking for claim status.
[AGENT][NEUTRAL] And [PII], what's the policy number?
[CUSTOMER][NEUTRAL] Uh, yes, the patient study is uh.
[CUSTOMER][NEUTRAL] AC um
[CUSTOMER][NEUTRAL] OK, just uh.
[CUSTOMER][NEUTRAL] The policy number is 02203110.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] And could you please repeat again your name, please?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] 2, OK.
[AGENT][NEUTRAL] And you'll use my name in today's date as reference for today's call. What's the patient's um name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] Uh, yes, the first name is, uh, [PII], and the last name is [PII]. Date of birth is.
[CUSTOMER][NEUTRAL] That about is [PII].
[AGENT][NEUTRAL] Thank you and you're checking claim status for what date?
[CUSTOMER][NEUTRAL] That service is [PII] total charge is $11,883.10.
[AGENT][NEUTRAL] OK, and what is the name of the facility?
[CUSTOMER][NEUTRAL] This is under Southside Regional Medical Center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And is it for just one day or is it an inpatient claim?
[CUSTOMER][NEUTRAL] Uh, this is just a one day outpatient.
[AGENT][NEUTRAL] For 11,000? Was it a surgery or something?
[CUSTOMER][NEUTRAL] $11,883.10.
[AGENT][NEUTRAL] Mhm. What type of service was it? Was it a surgery?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So I'm not showing a charge for that amount or claim for that amount, I mean.
[CUSTOMER][NEUTRAL] OK, let me just recheck you once more.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, can I have the member effective date?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] The policy effective date is [PII]. Uh, the policy is no longer active as of [PII].
[CUSTOMER][NEUTRAL] OK, and the timely farming limit.
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] OK, uh, thank you. Let's move to the next question.
[AGENT][NEUTRAL] You know that you can also check your status online at [PII], and I can help you create that account if you would like.
[CUSTOMER][NEUTRAL] Um, but just for today, I, I just want to finish my trip.
[AGENT][NEUTRAL] OK, how many statuses do you have?
[CUSTOMER][NEUTRAL] Actually, I have a total of
[CUSTOMER][NEUTRAL] 15 claims.
[AGENT][NEUTRAL] How many?
[CUSTOMER][NEUTRAL] 1515.
[AGENT][POSITIVE] OK, I'm, I'll be able to do 2 more.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] I'm ready for the 2nd 1.
[CUSTOMER][NEUTRAL] Uh, OK, so
[CUSTOMER][NEUTRAL] The next ID is 02046873.
[AGENT][NEUTRAL] 6873.
[CUSTOMER][NEUTRAL] And this is for the patient.
[CUSTOMER][NEUTRAL] Yes. And this is for the patient's first name, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me one moment. Give me one moment.
[AGENT][NEUTRAL] And [PII]'s date of birth?
[CUSTOMER][NEUTRAL] The patient's uh date of birth is [PII].
[AGENT][NEUTRAL] And the date of service in charge?
[CUSTOMER][NEUTRAL] Uh, date of services, uh, [PII], total charge is $1,371.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I do not show that date of service on file for [PII].
[CUSTOMER][NEUTRAL] OK, members effective date.
[AGENT][NEUTRAL] [PII], the termination date is [PII].
[AGENT][NEUTRAL] And the last policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I'm so sorry.
[CUSTOMER][NEUTRAL] Yes, so.
[CUSTOMER][NEUTRAL] So the next study yes.
[CUSTOMER][NEUTRAL] 021798 I'm sorry 02179837.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient's, uh, first name is [PII], last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Data service in charge?
[CUSTOMER][NEUTRAL] The [PII] total charges $5,134 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Did you say 5, 5,124 or 500, 5,134?
[CUSTOMER][NEUTRAL] 5,134.
[AGENT][NEUTRAL] 34 or 24?
[CUSTOMER][NEUTRAL] 34.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the name of the facility?
[CUSTOMER][NEUTRAL] This is on the Southside Original Medical Center.
[AGENT][NEUTRAL] OK, so I'm not showing a claim for that amount.
[AGENT][NEUTRAL] Excuse me, or from that facility.
[CUSTOMER][NEUTRAL] So, uh, now.
[CUSTOMER][NEUTRAL] How about uh another payment number 3563479?
[AGENT][NEUTRAL] OK, that shows a different hospital and a different amount.
[CUSTOMER][NEUTRAL] So you're saying that this is.
[AGENT][NEUTRAL] And so you already have the claim number?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Under that claim number which I provided to you is for different facility.
[AGENT][NEUTRAL] It's yeah it's a different facility than the one you gave me.
[CUSTOMER][NEUTRAL] So it is uh on Southside uh let me check Southside Regional Medical Center.
[AGENT][NEUTRAL] Yeah, that's not what's on the claim.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][POSITIVE] OK, uh thank you.
[CUSTOMER][NEUTRAL] And also, is it uh possible for you to transfer me back in the queue?
[AGENT][NEUTRAL] No, you'll have to call back.
[CUSTOMER][POSITIVE] OK, OK, I'm fine, thank you so much, that's all I need to have a very blessed day.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL. Have a good day.