AccountId: 011433970860
ContactId: 637d4b4f-f31a-4507-9571-f1222ba2561e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 519780 ms
Total Talk Time (AGENT): 121942 ms
Total Talk Time (CUSTOMER): 98115 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/637d4b4f-f31a-4507-9571-f1222ba2561e_20250521T17:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from from a provider's office, and we have received a check from y'all for $75 for a patient and this patient doesn't have a balance so I'm trying to figure out exactly what it's for.
[AGENT][NEUTRAL] OK, I can help you with that, um, [PII], can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] 02603488.
[AGENT][NEUTRAL] Alright, one moment while I look it up.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII] and her date of birth is [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said it was for $75?
[CUSTOMER][NEUTRAL] There is a balance out to the patient, yeah, um, it's for data service 4 15-25.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And there is a balance out to the patient and I didn't know if this needed just to be applied to that.
[CUSTOMER][NEUTRAL] You know I didn't know if this is like an HRA account or.
[AGENT][NEUTRAL] It's a hospital indemnity plan.
[CUSTOMER][NEUTRAL] HSA account.
[CUSTOMER][NEUTRAL] OK, so it's not actually part of the insurance.
[AGENT][NEUTRAL] It's secondary insurance.
[CUSTOMER][NEUTRAL] Secondary, OK, alright, um.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And it looks like
[CUSTOMER][NEUTRAL] So when we
[AGENT][NEUTRAL] Mhm. Go ahead.
[CUSTOMER][NEUTRAL] I don't have a secondary listed for her or have a card that shows the secondary information.
[CUSTOMER][NEUTRAL] Is there um the information that I can get from you for all of that?
[CUSTOMER][NEUTRAL] So we can enter it?
[AGENT][NEUTRAL] Well, we would be the, the primary.
[AGENT][NEUTRAL] Um, I'm sorry, the secondary, it looks like, let me see here.
[AGENT][NEUTRAL] Yeah, it looks like
[AGENT][NEUTRAL] Yeah, we should be secondary, so give me one moment, because they go through a staffing agency.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is the hospital indemnity plan so it looks like that $75 went towards.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Part of the claim and you said it was for what date of service again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Let me pull something up real quick and see what we can do here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you give me the provider's name?
[AGENT][NEUTRAL] Or the name of the hospital?
[CUSTOMER][NEUTRAL] Um, we are a doctor's office. We're Hartwell Family Practice.
[AGENT][NEUTRAL] Oh, I'm sorry, the name of it. OK, thank you.
[CUSTOMER][NEUTRAL] Yeah, uh huh.
[AGENT][NEUTRAL] It looks like it was just a partial payment on the $75.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It was given to you guys for.
[AGENT][NEUTRAL] It's weird because I have both, I have it in here twice so I'm wondering if you got it twice.
[AGENT][NEUTRAL] Give me just a moment. It looks like you guys are in here twice for the same claim number and I wanna make sure that we didn't accidentally double.
[AGENT][NEUTRAL] Double pay
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] And I apologize. Give me just one moment. I'm trying to figure out if it was an accidental double booking or, um, OK, just give me one moment.
[CUSTOMER][NEUTRAL] OK, that's fine.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, it's not a duplicate.
[AGENT][NEUTRAL] It looks like you did, it did pay for part of the services to meet towards.
[AGENT][NEUTRAL] Their calendar year maximum.
[AGENT][NEUTRAL] Because we were given, we were showing a bill.
[CUSTOMER][NEUTRAL] Yeah there was a deductible um from the primary, yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, um, quick question to mail medical claims to you, is it the [PII]?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Yes, that is it OK and then um.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Her policy number was the one that I gave you and that's what we need to use it for, right?
[AGENT][POSITIVE] Correct. Um.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah, it looks like this did go towards her calendar year maximum, so that's why it was given a check.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, all right, I will put it towards that visit then.
[AGENT][POSITIVE] OK, thank you so much. Thank you for calling APL and have a great day. Bye bye.
[CUSTOMER][POSITIVE] Thanks you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.