AccountId: 011433970860
ContactId: 6e19fa82-38cb-448b-b752-add1f172d6da
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 354209 ms
Total Talk Time (AGENT): 95946 ms
Total Talk Time (CUSTOMER): 92609 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/6e19fa82-38cb-448b-b752-add1f172d6da_20250102T17:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] My name is [PII] calling you from provider's office checking on claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status and what was your name again, please?
[AGENT][NEUTRAL] What is your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright and what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII] it's a direct line.
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's name?
[CUSTOMER][NEUTRAL] Yeah. The patient's first name is [PII] and the last name is [PII]
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, and then what is the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah. The policy number is?
[CUSTOMER][NEUTRAL] Yeah, it is 02.
[CUSTOMER][NEUTRAL] Yeah, I apologize. 02462268.
[AGENT][NEUTRAL] OK, let me look up that policy real quick for [PII] and we'll get you that claim information.
[AGENT][NEUTRAL] OK and then what is the data service?
[CUSTOMER][NEUTRAL] Yeah, date of service is [PII]. Total charge $728 even.
[AGENT][NEUTRAL] OK, and then what is the charges after primary paid their part?
[CUSTOMER][NEUTRAL] Uh, no, actually, we don't have the primary information.
[CUSTOMER][NEUTRAL] They have submitted this claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and then what is the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Yeah, Holy Cross Medical Group.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I will be right back.
[CUSTOMER][NEUTRAL] Sure. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, [PII], I have the claim pulled up and the claim was denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] OK. Can I get the claim number?
[AGENT][NEUTRAL] Yes, sir. It's 353.
[AGENT][NEUTRAL] 2338.
[CUSTOMER][NEUTRAL] 353 2
[AGENT][POSITIVE] 33, yes, that's correct.
[CUSTOMER][NEUTRAL] 338. Am I right?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, uh, when was the claim denied on?
[AGENT][NEUTRAL] The claim was processed on [PII].
[CUSTOMER][NEGATIVE] Yeah. Uh, as per checking into the APL portal, uh, for this claim number, I'm unable to pull the EOB.
[AGENT][NEUTRAL] You're unable to pull the EOB you said, sir?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I can fax it to you. What is your fax number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Attention to my name, [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I will send it right.
[CUSTOMER][NEUTRAL] When I will be receiving the fax?
[AGENT][NEUTRAL] I will send it, uh.
[AGENT][NEUTRAL] Like in the next couple of minutes.
[CUSTOMER][POSITIVE] OK, sure. Thank you.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEUTRAL] And may I have your name spell, please?
[AGENT][NEUTRAL] So any
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] Initial for last name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK, sure, it was great speaking with you. Have a good day. Bye bye.
[AGENT][POSITIVE] You too and thank you for calling APL you have a blessed one. Bye bye.
[CUSTOMER][NEUTRAL] You too bye.