AccountId: 011433970860
ContactId: 9074db56-cb3c-45a3-8ad9-070a198eefd3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 310359 ms
Total Talk Time (AGENT): 85391 ms
Total Talk Time (CUSTOMER): 92649 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/9074db56-cb3c-45a3-8ad9-070a198eefd3_20250113T19:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling to check status on a claim, please.
[AGENT][NEUTRAL] OK, I can help you with the claim. Uh, can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] [PII], it's [PII] My number is [PII]. That's correct.
[AGENT][NEUTRAL] Thank you, Ms. [PII]. What is the patient's name?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Patient is [PII], the last name [PII]
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And his policy number, please?
[CUSTOMER][NEUTRAL] That is, give me one moment.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] 02341476
[AGENT][NEUTRAL] OK, let me pull in his policy real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then can you give me the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] We billed $80,000. That's even.
[AGENT][NEUTRAL] OK, and then what is the charge after primary paid their part?
[CUSTOMER][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] OK, so UnitedHealthcare is primary and they left.
[CUSTOMER][NEUTRAL] A patient responsibility of $4,417.09.
[AGENT][NEUTRAL] Thank you and then what is the name of the provider you're calling for?
[CUSTOMER][NEUTRAL] Uh, this is Medical City Orthopedic spine.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, Miss. [PII], while I look up this claim for you and I'll be right back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, Ms. [PII], I've got the claim pulled up. Um, the claim has been denied because we need the copy of the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, and how can I get that to you? Am I able to fax it or email it?
[AGENT][NEUTRAL] Yes ma'am, you can fax it. Let me give you that um fax number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, I'll read it back to you. [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Is that attention to anyone in particular?
[AGENT][NEUTRAL] You could put attention claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and so do what I need to attach the claim as well as the ELB or just the EOB?
[AGENT][NEUTRAL] You can do just the EOB and then refer to this claim number. Let me give you the claim number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 354.
[AGENT][NEUTRAL] 8440.
[CUSTOMER][NEUTRAL] OK, 354-844-40.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, OK, I'll get that over right away.
[AGENT][NEUTRAL] OK, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][POSITIVE] No, ma'am. That was all. Thank you so much, [PII] for your help.
[AGENT][POSITIVE] You're very welcome. You have a blessed day and thanks for calling APL. Thank you, ma'am. Bye-bye.
[CUSTOMER][POSITIVE] You too. Thank you. Mm bye-bye.