AccountId: 011433970860
ContactId: 8bd7b7c4-fe09-4a6f-b93f-7ea45d4220d0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 426029 ms
Total Talk Time (AGENT): 139692 ms
Total Talk Time (CUSTOMER): 169272 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/8bd7b7c4-fe09-4a6f-b93f-7ea45d4220d0_20250130T14:30_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling APL this is how may I assist you?
[CUSTOMER][NEUTRAL] On
[CUSTOMER][NEUTRAL] Hello, my name is [PII] and I'm calling from the provider office.
[CUSTOMER][NEUTRAL] For claim status.
[AGENT][NEUTRAL] Sure, I can assist you with client status, Mr. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure, it is [PII].
[AGENT][NEUTRAL] And you're calling from which facility or provider?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It is Northeastern Health System Sequoia Memorial Hospital.
[AGENT][NEUTRAL] OK. And may I have the patient's policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah, sure. 02574089.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, sure. My name is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh sorry, [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yes, data services [PII] and total charges is $638.
[AGENT][NEUTRAL] OK, so that's [PII] and the amount is $638.
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] Alright, and Mr. [PII], for future, you can check claim status online through our website at [PII], and that's just optional.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEGATIVE] I tried uh to I tried to look in the on the website but while searching for this claim, uh there's no claim to display showing on the search claims.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's why I called.
[AGENT][NEUTRAL] OK, um, can you verify that date of service one more time?
[CUSTOMER][NEUTRAL] Yeah, sure, data services.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yeah, that's, that's better. Yeah, because we have nothing for the [PII], we do have something for the [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] uh.
[AGENT][NEUTRAL] OK, so it looks like right now we're waiting for information to confirm eligibility with benefits in a car, which is a third party. Once we receive that information, we'll go ahead and continue the processing of this claim.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] So, uh, you want, uh, information from the provider?
[AGENT][NEUTRAL] No, we're waiting eligibility for benefits in a card which is a third party.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Once we receive that information, we'll go ahead and continue the processing of the claim.
[CUSTOMER][NEUTRAL] OK, uh can you please, uh, repeat the department name from where you want, uh, where, where for you waiting for the eligibility.
[AGENT][NEUTRAL] It's not, no, no, no. It's not a department, Mr. [PII]. It's a third party, third party. It's not us, it's not the provider.
[CUSTOMER][NEUTRAL] Go
[CUSTOMER][NEUTRAL] Oh, OK. OK.
[CUSTOMER][POSITIVE] OK, thank you so much sorry I'm sorry again.
[AGENT][NEUTRAL] No, that's OK, no problem. All right. And um do you need the claim number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, yeah, sure.
[AGENT][NEUTRAL] OK, um let's see.
[AGENT][NEUTRAL] The claim number is 355.
[AGENT][NEUTRAL] 386 9.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and can you let me know that on which date it was received?
[AGENT][NEUTRAL] OK, let me get that for you one moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Provider
[CUSTOMER][NEUTRAL] uh
[CUSTOMER][NEUTRAL] 91324.
[CUSTOMER][NEUTRAL] I'd say.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the claim was uh received.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] On [PII], process [PII].
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Uh, processed, uh, it isn't processed it.
[AGENT][NEUTRAL] I'm sorry, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, you, you say just say that uh received on [PII] and processed on [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Processed, means uh it's been processed, this claim has been processed?
[AGENT][NEUTRAL] No, process means that it was reviewed and based on the information we're needing to confirm eligibility with benefits in a car. Processing means that it was reviewed.
[CUSTOMER][POSITIVE] OK. OK, thank you so much. Uh.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And uh may I have your good name, please?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, thank you so much sir for providing me the information and helping me out today and have a good day. Just let me know the reference number for this call.
[AGENT][POSITIVE] You're welcome. You as well. Thank you for calling APO.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] Do
[CUSTOMER][POSITIVE] OK thank you so much bye bye.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] You too.