AccountId: 011433970860
ContactId: 7ccc39ce-23ad-4fbb-8b9f-8d62b60cd0d8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 339959 ms
Total Talk Time (AGENT): 162989 ms
Total Talk Time (CUSTOMER): 126409 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/7ccc39ce-23ad-4fbb-8b9f-8d62b60cd0d8_20250422T17:56_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon, [PII]. My name is [PII] with Northside Hospital. May I get the status of a medical claim, please?
[AGENT][NEUTRAL] OK, [PII], you're needing status on one claim, is that correct?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] Yes ma'am I can help you with that.
[CUSTOMER][POSITIVE] Great, thank you so much.
[AGENT][NEUTRAL] [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] It's um [PII].
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number, please?
[CUSTOMER][NEUTRAL] Certainly, it's 243-5146 M as in Mary, L as in Lima, and the number 7.
[AGENT][NEUTRAL] OK. Thank you, [PII]. Give me a couple of moments, please, to get the member's information pulled up.
[CUSTOMER][POSITIVE] Sure, no problem.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And any information that I do provide today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII] and her date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] It's [PII]. The bill charges are $24,122 even.
[AGENT][NEUTRAL] OK, so you said that was 3:11 through 313. Is that correct?
[CUSTOMER][POSITIVE] Yes, yes, that is correct.
[AGENT][NEUTRAL] OK, so we do not have a claim on file for her for that data service on this policy, but this policy was not active for that data service.
[CUSTOMER][NEUTRAL] Oh, what's the termination date?
[AGENT][NEUTRAL] This policy termed [PII].
[AGENT][NEUTRAL] Let me see if there's another policy.
[CUSTOMER][POSITIVE] Wow.
[AGENT][NEUTRAL] There is. So you have an old policy number.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Give me a moment to get, yeah, give me just a moment to get that information pulled up, please.
[CUSTOMER][NEUTRAL] OK, what's the new policy number?
[CUSTOMER][POSITIVE] Sure, thank you.
[AGENT][NEUTRAL] OK, so,
[AGENT][NEUTRAL] The new policy number is 2609923.
[AGENT][NEUTRAL] Um, it shows an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But there is no claim on file on this policy either.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's because we billed it with the wrong number most likely.
[AGENT][NEUTRAL] Let me double check one thing.
[AGENT][NEGATIVE] Well, we didn't even receive with the wrong number. It's not, we didn't, we didn't get it period on either policy.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Didn't get it at all. So just to con OK, so just to confirm, the the claims mailing address is [PII] in Ok [PII].
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That is
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII]. Alright, and um is there an electronic payer ID you care to share?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] 60801.
[AGENT][NEUTRAL] And because this is a
[CUSTOMER][NEUTRAL] OK, although we do have to submit primary, it's a secondary policy, yes.
[AGENT][NEUTRAL] Yes, because we will have to, right, we will have to have the primary insurance's explanation of benefits as well.
[CUSTOMER][NEUTRAL] OK, so we'll have to mail it.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, thank you so much for confirming that information for me, [PII]. May I have a call reference number please?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes ma'am, you would use my name along with today's date and then one last thing, I don't know, you may already have this information, [PII], but once we've processed the claim here at APL, we do have a portal that you should be able to check claim status in, and the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, now you did say [PII] in [PII]?
[AGENT][POSITIVE] Yes, ma'am. I like our company name, American Public. It's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Alright, great, just wanted to make sure, thank you and um may I have OK did you did say the call reference number would be your name and I got that. Alright, well thank you so much for your assistance. I hope that you have a wonderful day and you do the same. Thank you.
[AGENT][NEUTRAL] Yes ma. Sure.
[AGENT][NEUTRAL] Uh today's date.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] Uh, I hope you do too, [PII]. And again, if that is all I can help you with, thank you so much.
[CUSTOMER][POSITIVE] You're welcome take care now bye bye.
[AGENT][NEUTRAL] For calling APL.
[CUSTOMER][POSITIVE] Absolutely take care.
[AGENT][NEUTRAL] Too. Bye-bye.