AccountId: 011433970860
ContactId: 549acf48-6f07-4c4d-8c6e-52d90a7a589b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 440859 ms
Total Talk Time (AGENT): 111365 ms
Total Talk Time (CUSTOMER): 159604 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/549acf48-6f07-4c4d-8c6e-52d90a7a589b_20250415T17:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, I'm [PII] Last name initial, it's [PII], calling from the office to check up on the claims.
[AGENT][NEUTRAL] OK, I can help you with the claim, [PII]. May I please get your callback number, sir?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII]. Policy number is 025.
[CUSTOMER][NEUTRAL] 732
[CUSTOMER][NEUTRAL] 45.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK, and then what is the date of service for [PII]?
[CUSTOMER][NEUTRAL] Date of service it's [PII].
[AGENT][NEUTRAL] And the charge amount, please?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, the charge amount is $2,379.14.
[AGENT][NEUTRAL] OK, and then what's the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Charge amount. Let me see.
[AGENT][POSITIVE] OK, take your time.
[CUSTOMER][NEUTRAL] Uh, just give me one second.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Like, uh, primary paid $1,419.92.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, and so what was the balance left to pay for the charge amount after primary?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh, like we have billed that. Let me just, uh, minus that amount, OK? Let me just tell you that, like I'll tell you.
[AGENT][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But I know that was gonna
[CUSTOMER][NEUTRAL] OK. So like the balance amount, it's $959.22.
[AGENT][NEUTRAL] Thank you, sir. And then can I please get the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Yes, it's Mission Hospital.
[AGENT][NEUTRAL] OK, [PII], I'm gonna put you on a brief hold while I look up this claim and I will be right back, sir.
[CUSTOMER][NEUTRAL] So, and can I just, uh, like, uh, before going, can you just provide me your name?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][POSITIVE] OK, thanks for that. Yeah, you can take your time.
[AGENT][POSITIVE] Thank you. OK, thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you for holding for me, [PII]. I have the claim pulled up.
[AGENT][NEUTRAL] The claim number is 356.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 1556.
[AGENT][NEUTRAL] And the claim has been denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] You need the primary UV, OK.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] And like, uh, we have sent, uh, like try to send you on [PII]. So I'll like uh just to confirm, can you just see like if you have received anything from our site?
[AGENT][NEGATIVE] No, sir, we have not received anything since February.
[CUSTOMER][NEUTRAL] OK, and let me see like how how we have sent that.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, like, uh, we have sent you by mailing like, uh, [PII].
[AGENT][NEUTRAL] OK, so it's 248,950.
[CUSTOMER][NEUTRAL] Uh, like, uh, do you have a fax number?
[AGENT][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 94.
[AGENT][NEUTRAL] 23.
[CUSTOMER][NEUTRAL] OK. I'll, I'll just confirm you that.
[AGENT][NEUTRAL] We also have a payer ID number.
[CUSTOMER][NEUTRAL] Oh, OK, yeah, please, uh, like you can provide me your your ID too.
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][NEUTRAL] OK. And like the fax number, I'll just repeat it. It's 187.
[CUSTOMER][NEUTRAL] 736
[CUSTOMER][NEUTRAL] 594.
[CUSTOMER][NEUTRAL] 23
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. Like I will just send you that over to that fax number, OK? Can you just provide me the call reference number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, you can use my name, [PII], in today's date.
[CUSTOMER][POSITIVE] OK, [PII]. Thank you for your assistance. Thank you so much for assisting us.
[AGENT][POSITIVE] You're very welcome, [PII]. Is that everything I can help you with before we go?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, well, you have a wonderful week and thanks for calling APL.
[CUSTOMER][POSITIVE] Yes, you too. Bye.
[AGENT][NEUTRAL] Bye-bye.