AccountId: 011433970860
ContactId: 883b5927-f73d-4a1f-8d77-e2acac8fcddd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 750599 ms
Total Talk Time (AGENT): 217611 ms
Total Talk Time (CUSTOMER): 202301 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/883b5927-f73d-4a1f-8d77-e2acac8fcddd_20250224T19:35_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. I'm calling from provider office and checking claim status.
[AGENT][NEUTRAL] I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] 01888636.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh, phone number I have [PII]. Direct line, no extension.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name, I have [PII] [PII].
[AGENT][NEUTRAL] Thank you for that information and you stated that you're checking a claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, could you verify the date of service and the total charge?
[CUSTOMER][NEUTRAL] [PII] for the bill amount $225.09 28 cents.
[AGENT][NEUTRAL] Uh, 22528 cents. And give me the date of service again, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thanks.
[AGENT][NEUTRAL] OK, so now I do not show a date of service for [PII] for [PII].
[CUSTOMER][NEUTRAL] OK, can we go for next service? [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the total charge?
[CUSTOMER][NEUTRAL] $328.94.
[AGENT][NEUTRAL] And did you have any other dates of service?
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] I have multiple service, 72 service for this patient. Uh, it is for date range [PII] to.
[CUSTOMER][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] [PII]. That's the date range I have.
[CUSTOMER][NEUTRAL] Do you have any claim for this details for this patient?
[AGENT][NEUTRAL] OK, so is it an inpatient claim or you're saying that you have dates of service within that range that were billed separately?
[CUSTOMER][NEUTRAL] Uh separately bill it was separately billed and it was inpatient.
[AGENT][NEUTRAL] OK, so I have [PII], [PII]. Give me the individual dates. So [PII], [PII] and [PII]?
[CUSTOMER][NEUTRAL] Yes, so do you have a claim for the [PII]?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm checking. Give me one second, but I need to solidify the dates of service first. So what is the total charge for [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I already give you that. Uh, we already talked about that. It's [PII] is $329.28 dollars 94 cents.
[AGENT][NEUTRAL] I was asking for the total charge for [PII].
[CUSTOMER][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] $225.28.
[AGENT][NEUTRAL] OK, so I don't show any claims on file from [PII].
[AGENT][NEUTRAL] I do show one chart and I don't show anything on file for [PII].
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] And I'm sorry, I, I'm sorry for the December, any December charge you gave me. What is it for? Is it for diagnostic?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Lab or testing?
[CUSTOMER][NEUTRAL] It is for hospital observation care.
[AGENT][NEUTRAL] OK, so it's the facility charge or the professional charge?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Professional charges.
[AGENT][NEUTRAL] And what's the name of the facility?
[CUSTOMER][NEUTRAL] Do
[CUSTOMER][NEUTRAL] Uh, name of the facility. Give me one moment.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Saint Mary Regional Medical.
[AGENT][NEUTRAL] All right, I'm not showing any of these dates of service on file for this patient.
[CUSTOMER][NEUTRAL] Got it. OK. And uh may I have the correct claim mailing address, ma'am, for future reference?
[AGENT][NEUTRAL] American public, American public life.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 248
[AGENT][NEUTRAL] 950.
[AGENT][NEUTRAL] Oklahoma City, Oklahoma.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and policy effective rate?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] This policy is no longer active as of [PII].
[CUSTOMER][NEUTRAL] Uh, [PII], but we have received a, uh, we have received a payment of this claim. Is it possible you can check is there any date of service?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Policies active or not in our service.
[AGENT][NEUTRAL] You said that you received payment for what date of service?
[CUSTOMER][NEUTRAL] I just, uh, we received payment for the service. Let me give you that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Do you have a claim number?
[CUSTOMER][NEUTRAL] 26.
[CUSTOMER][NEUTRAL] Uh, let me check if I have that.
[CUSTOMER][NEUTRAL] No, ma'am. I do not have a claim number. Let me check, ma'am. Give me one moment.
[CUSTOMER][NEUTRAL] Uh is there any payer ID you have?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Let me give you that. Yeah.
[CUSTOMER][NEUTRAL] Information for this claim. Give me one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, ma'am. I'm not showing any.
[CUSTOMER][NEUTRAL] I do not have that.
[CUSTOMER][NEUTRAL] I will try it once again.
[CUSTOMER][NEUTRAL] But we dry.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I have a claim number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Where is the claim number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 3551323
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 3551323.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Well, I have a, it was paid on [PII]. I have a check number also.
[AGENT][NEUTRAL] OK, give me 1 2nd.
[AGENT][NEUTRAL] Is it for [PII] or for a different patient?
[CUSTOMER][NEUTRAL] It is for [PII]'s spouse, uh, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Dependent.
[AGENT][NEUTRAL] OK. So, um, that claim number is under a different policy number and [PII] is a dependent on that policy.
[AGENT][NEUTRAL] And I do see the claim?
[AGENT][NEUTRAL] But it's a different policy.
[CUSTOMER][NEUTRAL] May I know the policy ID?
[CUSTOMER][NEUTRAL] Uh, what do you have?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] I'm sorry, it's 01888.
[AGENT][NEUTRAL] 649.
[CUSTOMER][NEUTRAL] So that's the same policy I used.
[AGENT][NEUTRAL] You gave me 01888636.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So it should be updated right and then they will this time.
[AGENT][NEUTRAL] Yes, so under policy number.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] 01888649
[AGENT][NEUTRAL] This policy effective date is [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And I actually show.
[AGENT][NEUTRAL] This policy is active at this time.
[AGENT][NEUTRAL] I did check the other dates of service that you gave me, but I don't see those. The [PII].
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Um, so you would, you can resubmit under the um policy number that I gave you ending in 8649.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the the the amount that you gave me for those dates, is that the total bill amount or is that the amount that's due?
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] It's a bill amount.
[AGENT][NEUTRAL] OK, so I do not show those amounts on file under the policy ending in 8649?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I have the uh
[CUSTOMER][NEUTRAL] Reference number?
[AGENT][NEUTRAL] My name and today's date, [PII]
[AGENT][NEUTRAL] First initial of my last name is [PII].
[AGENT][NEUTRAL] And I'm gonna go ahead and document the other dates of service that you gave me under the 1888649 policy number.
[AGENT][NEUTRAL] Instead of the one you gave me?
[CUSTOMER][POSITIVE] Thank you, ma'am.
[AGENT][NEUTRAL] Mhm. Any other questions, [PII], I can help out with today?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Uh no, ma'am. Thank you. I appreciate it.
[AGENT][POSITIVE] Oh, you're welcome. Thank you for calling APL. Have a good day.