AccountId: 011433970860
ContactId: 723b2d84-3162-4575-bb9b-aa6820678607
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 466350 ms
Total Talk Time (AGENT): 135176 ms
Total Talk Time (CUSTOMER): 115738 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/723b2d84-3162-4575-bb9b-aa6820678607_20250206T20:00_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, sir. Uh, I'm [PII] calling from provider's office to check my team status.
[AGENT][POSITIVE] All right, [PII]. I'm happy to check on a claim for you today. What is the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, sure, just a moment, let me send the details. My system got it stuck at this moment.
[CUSTOMER][NEUTRAL] Yeah, almost there.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, yeah, got it. So the numbers ID would be 01940423.
[AGENT][NEUTRAL] All right, thank you. One moment.
[AGENT][NEUTRAL] May I please have the patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient's name would be [PII], and date of birth would be [PII].
[AGENT][NEUTRAL] Thank you for that. And then date of service?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] Thank you and the bill amount?
[CUSTOMER][NEUTRAL] $8,193.63.
[AGENT][NEUTRAL] Do you have an amount after the primary?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Do you have an amount after the primary?
[CUSTOMER][NEUTRAL] Uh, you want the primary details?
[AGENT][NEUTRAL] I'm asking if you have a billed amount after the primary paid.
[CUSTOMER][NEUTRAL] Yeah, that was the only the amount that we got provided from our end.
[AGENT][NEUTRAL] The $8,356.93.
[CUSTOMER][NEUTRAL] Yeah, the bill amount would be.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And data service again to confirm was [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, I don't show any claims on file for that billed amount, unfortunately.
[AGENT][NEUTRAL] Are you still there?
[CUSTOMER][NEUTRAL] Uh hello. Uh, yeah, I'm there. Actually, I'm asking you that, uh, is there any chance that you have the best amount of $300 because of the primary paid, they're expecting $300 from you.
[AGENT][NEUTRAL] So there's only one claim I show on file for that date of service and it looks like the charge amount was for $300. We sent a benefit payment in the amount of $250.
[CUSTOMER][NEUTRAL] OK. $250.
[AGENT][NEUTRAL] 250 was the max amount payable.
[CUSTOMER][NEUTRAL] OK. Go ahead.
[CUSTOMER][NEUTRAL] Mhm. Uh, was there any patient responsibility?
[AGENT][NEUTRAL] We're not able to advise on the patient responsibility that would be up to the facility or provider.
[CUSTOMER][NEUTRAL] OK. May I have the claim number?
[AGENT][NEUTRAL] Claim number is 3,559,360.
[CUSTOMER][NEUTRAL] OK. It's 355-9360. Am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] May I know the claim received and also the processed date.
[AGENT][NEUTRAL] Claim is received [PII].
[AGENT][NEUTRAL] Claim is processed [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. May I know the mode of payment? Is it free after your check?
[AGENT][NEUTRAL] Uh, one moment, let me double check that.
[AGENT][NEUTRAL] It looks like it was a single check.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My the check number?
[AGENT][NEUTRAL] 202-6004.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Ma I know when check got issue?
[AGENT][NEUTRAL] And that was on [PII].
[CUSTOMER][NEUTRAL] Uh, may I know when the check is gonna clear?
[AGENT][NEUTRAL] Uh, the check is still outstanding, so we don't have a date.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] So the allowed amount was $300 right?
[AGENT][NEUTRAL] Uh, the billed amount was 300, the allowed amount was 250. That was the next payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And it was a single check as you mentioned. Um, can you spell out your name for me?
[AGENT][NEUTRAL] My name is spelled [PII].
[CUSTOMER][NEUTRAL] OK. May I have the call reference number?
[AGENT][NEUTRAL] Call references my name with my last initial and today's date. My last initial is [PII].
[CUSTOMER][NEUTRAL] OK. It's [PII] [PII], right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Got it thank you so much, [PII]. Have a great day bye bye.
[AGENT][NEUTRAL] You too, [PII]. Bye-bye.