AccountId: 011433970860
ContactId: 90c5ac56-3113-4799-b748-6bdd0eb3b979
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 456890 ms
Total Talk Time (AGENT): 165654 ms
Total Talk Time (CUSTOMER): 172788 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/90c5ac56-3113-4799-b748-6bdd0eb3b979_20250620T14:20_UTC.wav
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[AGENT][POSITIVE] Thank you for
[AGENT][NEUTRAL] Hello, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Jackson Memorial Hospital, checking out our client status.
[AGENT][NEUTRAL] OK, I can check on that claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] OK, uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, uh, callback number is [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] The policy number is 02432932.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] The member name was [PII], and the date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] Data services, so I know.
[CUSTOMER][NEUTRAL] [PII] and the total charges $1,154 even.
[AGENT][NEUTRAL] OK, and then do you have the tax ID for this provider?
[CUSTOMER][NEUTRAL] Yes, uh, tax ID is [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, so I've only got one claim for that date of service from this provider, and that was for the amount of $60. Was that the amount after major medical paid?
[CUSTOMER][POSITIVE] Uh, actually, the client, the total amount of $1,154 saving.
[AGENT][NEUTRAL] Right, is that before or after major medical paid?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Actually, I need to verify um that the client has been received for
[CUSTOMER][NEUTRAL] 1100. Yeah. $1,154 even, am I right?
[AGENT][NEUTRAL] OK, give me just a moment. Let me take a look.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 1,154. OK, yes, I do see that's the total excuse me, um, and I guess the remaining balance that was for us was $60 so yes, we did receive this claim and we paid that benefit of $60.
[CUSTOMER][NEUTRAL] And the remaining balance would be?
[AGENT][NEUTRAL] I don't see a remaining balance. We were billed for $60.
[CUSTOMER][NEUTRAL] Oh, so the claim hasn't processed that second, am I right?
[AGENT][NEUTRAL] I do see the total bill charges as $1,154. However, the remaining balance of $60 after major medical paid is what we paid.
[CUSTOMER][NEUTRAL] Yeah, that I can understand. I'm just asking, but did the client hashing process as primary or secondary?
[AGENT][NEUTRAL] This is their secondary medical policy.
[CUSTOMER][POSITIVE] Thank you so much for verifying me that and uh
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So, can you provide me the contractual amount?
[AGENT][NEUTRAL] Um, um, we were built for.
[CUSTOMER][NEUTRAL] Because the primary
[AGENT][NEUTRAL] I'm showing here the primary, the total amount was $1,154. The only amount left over was $60 after primary paid, and that is what we paid.
[CUSTOMER][NEUTRAL] Um, it's just our attention to.
[AGENT][NEUTRAL] If you'd like I can send you a copy of this EOB that has that information.
[CUSTOMER][NEUTRAL] That's theojalalaramo.
[CUSTOMER][NEUTRAL] Uh, yeah, sure.
[AGENT][NEUTRAL] What was that fax number for you?
[CUSTOMER][NEUTRAL] The fax number is going to be [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was 866.
[CUSTOMER][NEUTRAL] And also I
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 793-273-8
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, you're right.
[AGENT][NEUTRAL] OK, I'll go ahead and get that sent now. What other questions did you have for me?
[CUSTOMER][NEUTRAL] Uh, I just want to know whether there is any patient responsibility, uh, the total allowed amount it says 60.
[AGENT][NEUTRAL] It was 60, but either way we don't say what is patient responsibility that is up to the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Gotcha.
[CUSTOMER][POSITIVE] Thank you so much for reframing that. And the claim number will be, please?
[AGENT][NEUTRAL] Claim number is 3592043.
[CUSTOMER][POSITIVE] OK, gotcha. Thank you.
[AGENT][NEUTRAL] Yeah, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Uh, how much, how much time it may take to visit the EUB?
[AGENT][NEUTRAL] Uh, I just sent it, so I would say within about 10 minutes or so.
[CUSTOMER][NEUTRAL] OK, got you. Thank you for verifying me that and uh.
[AGENT][POSITIVE] Of course thank you I hope.
[CUSTOMER][NEUTRAL] The check number, please?
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[AGENT][NEUTRAL] Yes, that check number is 20.
[CUSTOMER][NEUTRAL] Um, the check number.
[AGENT][NEUTRAL] Yes, it is 204-034-6.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is it about payment or a single?
[AGENT][NEUTRAL] Single check.
[CUSTOMER][NEUTRAL] OK. Gotcha. And uh
[CUSTOMER][NEUTRAL] Um, the issue date and the clear date, please?
[AGENT][NEUTRAL] Uh, that issue date was [PII], and I'm showing it did clear on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK, gotcha. Thank you. And the pay to address, please?
[AGENT][NEUTRAL] Uh, that was [PII].
[CUSTOMER][POSITIVE] Thank you so much for verifying me that. Um, here, that's all. Thank you so much for your kind assistance.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Yeah, so have a great day and happy weekend. Bye bye. And the reference number please?
[AGENT][NEUTRAL] You too thank you bye bye. Oh, reference number would be my first name, last initial, and today's date. Uh, so my name is spelled [PII] last initial is A.
[CUSTOMER][NEUTRAL] Um, reference
[CUSTOMER][POSITIVE] Thank you so much, [PII], for your kind assistance.
[AGENT][NEUTRAL] Of course,
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Yeah, bye bye.