AccountId: 011433970860
ContactId: 689b7c5b-01c5-4955-a94d-896dd4480ebf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 336769 ms
Total Talk Time (AGENT): 152757 ms
Total Talk Time (CUSTOMER): 145210 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/689b7c5b-01c5-4955-a94d-896dd4480ebf_20250331T16:17_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII], my name is [PII]. I'm with Baptist Memorial Hospital, and we have a patient that came into our facility back on [PII] or 24, and we sent a claim out to you all, but we never heard back from it and so we do a doing a status check on it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] It would be my pleasure to assist you with that claim status, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] The policy number is 01446580.
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] And what is the patient's name and date of birth, please, sir?
[CUSTOMER][NEUTRAL] The date, uh the patient's name is [PII]
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. Now I am checking [PII]'s policy uh for claim status 82424. What was that billed amount?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The bill amount for this particular claim was $6,927.57. Uh, Blue Cross did pay everything but the 2,17594 cents.
[AGENT][POSITIVE] All right, thank you.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you said that was Baptist Hospital?
[CUSTOMER][NEUTRAL] Yes ma'am, of golden triangle.
[AGENT][NEUTRAL] Oh right
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Now [PII], I'm showing that we received that claim on [PII].
[AGENT][NEUTRAL] It was processed on [PII] and an EOB would have gone out the following business day, the Baptist Hospital, stating the reason um.
[CUSTOMER][NEUTRAL] You see, when at the same day.
[AGENT][NEUTRAL] The next day, the next business day.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] OK, we haven't received anything. That's the
[AGENT][NEUTRAL] And
[CUSTOMER][NEGATIVE] Is the uh the reason why I'm calling because um we didn't receive anything at all.
[AGENT][NEUTRAL] OK, well, the
[CUSTOMER][NEUTRAL] For that particular one.
[AGENT][NEUTRAL] Now this claim was denied as the services are rendered after the policy termed. Mr. [PII]'s policy termed on 8-1-24.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] 8124.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, so he didn't have coverage completely. All right, that makes a lot of sense. The reason why we didn't get a claim.
[AGENT][NEUTRAL] He did.
[AGENT][NEUTRAL] Did you want that claim number?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh yes, ma'am, please.
[AGENT][NEUTRAL] The claim number is 350.
[AGENT][NEUTRAL] 6798.
[CUSTOMER][NEUTRAL] OK, um, because I tried to go online to pull up the American public, but
[CUSTOMER][NEUTRAL] I can't get anything. So, uh, that was the reason why, uh, the second reason why I was calling, uh.
[AGENT][NEUTRAL] Did you try it, you have that claim number? You want to try it again? If not, I can fax it to you.
[CUSTOMER][NEUTRAL] For that, um,
[CUSTOMER][NEUTRAL] Yes ma'am, please can you fax it to me?
[AGENT][NEUTRAL] I can. Give me just one second, [PII]. Let me get that up.
[AGENT][NEUTRAL] I pull it up for you. It'll take me just a minute. Can I put it to your attention?
[CUSTOMER][NEUTRAL] Yes, ma'am, please.
[AGENT][POSITIVE] OK, give me just one second and I'll get that ready for you.
[AGENT][NEUTRAL] Or 2 seconds depending on my computer.
[CUSTOMER][NEUTRAL] Yeah, believe me, I understand.
[AGENT][NEUTRAL] I feel like we hurry up and wait. That's right.
[CUSTOMER][NEUTRAL] Yeah, these computers got remind us on.
[AGENT][NEUTRAL] Just hurry up and wait.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] But if you'll just give me one second.
[CUSTOMER][NEUTRAL] So you're doing all right today?
[AGENT][POSITIVE] I'm doing well. How about yourself?
[CUSTOMER][POSITIVE] Doing good.
[AGENT][POSITIVE] Yeah, it's, it's, it's a Monday, but it's a beautiful Monday. That's right. Every day is a great day.
[CUSTOMER][POSITIVE] It's a great day
[CUSTOMER][NEUTRAL] Yes it is.
[AGENT][NEUTRAL] You know, I have just learned of.
[AGENT][POSITIVE] Through faith and everything, that every day is a great day.
[CUSTOMER][POSITIVE] Yes ma'am, yes ma'am.
[AGENT][NEUTRAL] Alright, let's see, [PII], I am ready for that fax number please sir.
[CUSTOMER][NEUTRAL] That number would be 901.
[CUSTOMER][NEUTRAL] 227
[CUSTOMER][NEUTRAL] 5434.
[AGENT][NEUTRAL] Alright, let me just verify that fax number. I'm sending this EOB to [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] All right, [PII], that is on the way for you. You should be receiving that shortly. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK, is there a reference number for you?
[AGENT][NEUTRAL] You would choose my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] OK, so it's just one [PII] and [PII], OK.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] Alright then alright well thank you so very much, ma'am. You have a wonderful day.
[AGENT][POSITIVE] Well, it has been my pleasure and I hope you have a wonderful day as well, and thank you for calling APL. You take care.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.