AccountId: 011433970860
ContactId: 6356d170-abbe-405e-9695-62db20235632
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 460339 ms
Total Talk Time (AGENT): 187308 ms
Total Talk Time (CUSTOMER): 116225 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/6356d170-abbe-405e-9695-62db20235632_20250530T12:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII] from Holy Cross Hospital. I'm checking status on the claim.
[AGENT][NEUTRAL] OK, JD, you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII] direct?
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] The policy number I have is.
[CUSTOMER][NEUTRAL] 0168.
[CUSTOMER][NEUTRAL] Wait, 01678790 ML 8.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] And you said it was 0168?
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] No, 10678.
[AGENT][NEUTRAL] 78. OK.
[CUSTOMER][NEUTRAL] 790 ML 8.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], birthday [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount?
[CUSTOMER][NEUTRAL] 110 2514 $1,475.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, JD, so I do show that this claim was received. It was received on [PII] and processed on [PII].
[AGENT][NEUTRAL] The claim number is 3600089. There was a benefit issued in the amount of $300.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that was on single check too.
[CUSTOMER][NEUTRAL] You said $300,300 300 dollars, what?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] On a single check.
[CUSTOMER][NEUTRAL] That was the payment.
[AGENT][NEUTRAL] That was the payment. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] As of now, the check is still showing as open and the check number is 2043937.
[AGENT][POSITIVE] It is still showing as outstanding.
[CUSTOMER][NEUTRAL] Is it a patient responsibility?
[AGENT][NEUTRAL] We do not determine patient responsibility. This is a supplemental policy that helps with their co-pays, deductibles, and co-insurance amount of covered services.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you need
[CUSTOMER][NEUTRAL] So the check haven't been.
[AGENT][NEUTRAL] Mhm. Go ahead. No, ma'am, go ahead with your question.
[CUSTOMER][NEUTRAL] Go ahead. Uh, if I need what?
[AGENT][NEUTRAL] A copy of that explanation of benefits for this claim, you can print that now that you have the claim number from our portal by going to [PII].
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] But yes, ma'am, as of now, this does still show as outstanding. Again, it was just issued on [PII].
[AGENT][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] All righty then.
[CUSTOMER][NEUTRAL] And you said I, so you can send me an EOB.
[AGENT][NEUTRAL] Do you not have the ability to access the internet, JD?
[CUSTOMER][NEUTRAL] Uh, uh, give me the website again.
[AGENT][POSITIVE] Secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Spell secure.
[CUSTOMER][NEUTRAL] [PII] OK, [PII] It didn't look right. Secure, you said secure what? 00, put an ED at the end, secure what?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][POSITIVE] Uh-huh, secured.
[AGENT][NEUTRAL] AM [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And if you'll give me a moment, I can go ahead and fax this one to you and then you can use that portal for the future.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For printing AB, so just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For me to get that pulled up.
[AGENT][NEUTRAL] And will it need to be put to your attention?
[CUSTOMER][NEUTRAL] Payment posting.
[AGENT][NEUTRAL] Attention payment posting.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] And give me a good fax number for you, please.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And again, you said the department to send it to was, what did you say one more time? I'm so sorry.
[CUSTOMER][NEUTRAL] Payment, payment, payment posting.
[AGENT][NEUTRAL] Payment posting, OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] And again, that fax number was [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, just need a reference.
[AGENT][NEUTRAL] OK, well, that has been faxed to. Yes, ma'am. And the reference number for this call is my name along with today's date.
[CUSTOMER][POSITIVE] All righty.
[CUSTOMER][NEUTRAL] What's your last initial, [PII]?
[AGENT][NEUTRAL] [PII], and yours?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] Nope, that's all I have. You have a good day.
[AGENT][POSITIVE] OK. Well, thank you so much for calling APO and I hope you have a nice day also.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] All right, bye bye.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] On 300.
[CUSTOMER][NEUTRAL] Right, and they paid the 300. Alright, alright, alright.