AccountId: 011433970860
ContactId: 50c8a948-3d4a-4197-b44b-fda8bd27da68
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 559150 ms
Total Talk Time (AGENT): 143262 ms
Total Talk Time (CUSTOMER): 176293 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/50c8a948-3d4a-4197-b44b-fda8bd27da68_20250327T20:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. This is [PII]. I'm calling from provider office, Jackson Memorial Hospital looking on a client status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. And you said that was Jackson Memorial Hospital, right?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yes, you're right. Could you please spell out your name for me? I couldn't able to get it earlier.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Yes, sir. Yes sir, that's it.
[CUSTOMER][POSITIVE] Thank you very much, [PII], for spell out your name.
[AGENT][NEUTRAL] You're welcome. Can I please get your callback number, [PII], just in case our call gets disconnected?
[CUSTOMER][NEUTRAL] Uh, callback number is gonna be [PII]. It would be a direct line to.
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Uh, let me go with the policy number. The policy number, it starts with uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Number 02419775 M as in Mike L as in Lima number 8.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] OK, thank you, sir.
[CUSTOMER][NEUTRAL] And the insured name is uh [PII].
[CUSTOMER][NEUTRAL] And the date of birth would be.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me pull up this policy for us real quick.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Actually, the name which I gave is for insurer name, but the patient name is uh [PII], who born on [PII].
[AGENT][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] OK, thank you. And then can you give me the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Uh, the first, I do have two data of services for the same patient. The first one is [PII] with the total charge amount of $968 even.
[AGENT][NEUTRAL] OK, and then what's the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh, they have paid the claim for, uh, something. I don't know that, but they have left over $100 of copay.
[AGENT][NEUTRAL] $100 OK.
[AGENT][NEUTRAL] Alright, let me look up this data service first. I'm gonna put you on a brief hold while I, I pull in the claim for us and I will be right back, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Sure, sir. You take your time. I'll wait.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Huh.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, OK, [PII], so looking on data service of [PII], I do not find a claim on file.
[CUSTOMER][NEUTRAL] So the patient is active during the service, am I right?
[AGENT][NEUTRAL] Yes, sir. The effective date of the policy is [PII] and the policy is current.
[CUSTOMER][NEUTRAL] Uh thank you very much. Can you please check out the another date of service which was for [PII] with total charge amount of $727.
[CUSTOMER][NEUTRAL] Primary pay was left over uh the same $100 as a co-pay.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 100. OK, yes sir, I'm gonna put you on a brief hold again while I look up that claim. I'll be right back sir.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Oh my gosh.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] You are.
[AGENT][NEUTRAL] Thank you, [PII], for holding for me. So looking uh for the date of service of [PII], I do not find a claim on file for that date of service either, sir.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Thank you very much for providing me all the information. And just to confirm the uh claim mailing address on the payer ID, let me tell you uh the pay ID is uh 60801. Am I right?
[AGENT][POSITIVE] Yes, that's that's correct.
[CUSTOMER][NEUTRAL] The mailing address would be [PII].
[CUSTOMER][NEUTRAL] [PII]. Am I right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Um, what's the time limit to submit the secondary claim?
[AGENT][NEUTRAL] And we have a
[AGENT][NEGATIVE] Uh, we do not have a timely filing limit.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So we can submit whenever uh the claim needs to be submitted, right?
[AGENT][NEUTRAL] Right, any time is fine as long as the patient was covered on the data service you can file a claim at any time.
[CUSTOMER][POSITIVE] Thank you very much, uh, sorry, for providing me all the information that's it for today. Yes you may, uh, go ahead with the call up and something will buy.
[AGENT][NEUTRAL] Yes sir, you can use my name [PII] in today's date and just so you know we have a fax number for claims too. Would you like the fax number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Thanks for
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. That's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thanks a lot attention too.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Or anything else I can help you with?
[CUSTOMER][NEUTRAL] What we need to use for attention.
[AGENT][NEUTRAL] Uh, claims, I'm sorry, attention claims.
[CUSTOMER][POSITIVE] Thank you very much, [PII], for providing me all this information. That's it for today. Take care. Bye-bye. Have a wonderful rest of your day.
[AGENT][POSITIVE] You too. You have a good day too, and thank you for calling APL Jack bye bye.