AccountId: 011433970860
ContactId: 92110b43-de75-4ad4-86c4-9ba85e3dc8a7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 520280 ms
Total Talk Time (AGENT): 111320 ms
Total Talk Time (CUSTOMER): 99622 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/92110b43-de75-4ad4-86c4-9ba85e3dc8a7_20250404T17:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, my name is [PII] calling from Lafayette Surgical, and I'm wanting to check the status of the claim, please.
[AGENT][NEUTRAL] OK, I can help you with um a claim status, Ms. [PII]. Can I please get your callback number?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], [PII]. The policy number is 01694190.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK and then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] [PII] for $77,555.33.
[AGENT][NEUTRAL] OK, and then what's the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh, OK, wait, let me figure that out.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It looks like it's $336.59.
[AGENT][NEUTRAL] Thank you, you said that you were calling from Lafayette. I got the Lafayette part. I didn't get the.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, Lafayette Surgical Specialty Hospital.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look up this claim for you, Ms. [PII], and I'll be right back.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][POSITIVE] Sounds good thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, [PII]. I've got the claim number for you. It's 3558691.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim was denied because the inpatient benefit amount for the calendar year had been maxed.
[CUSTOMER][NEUTRAL] OK, inpatient amount.
[AGENT][NEGATIVE] Yes, so exhausted.
[CUSTOMER][NEUTRAL] Benefit
[CUSTOMER][NEUTRAL] Is there, uh, can you tell me what date that was processed?
[CUSTOMER][NEUTRAL] Because we still have not received the remit stating that.
[CUSTOMER][NEUTRAL] Benefits exhausted
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. Is there anything else I can help you with, [PII] before we go?
[CUSTOMER][NEUTRAL] Oh, what can you tell me what was the date that y'all processed it?
[AGENT][POSITIVE] Yes, ma'am. I'm sorry.
[AGENT][NEUTRAL] I can give you that date.
[CUSTOMER][NEUTRAL] Oh, that's OK.
[AGENT][NEUTRAL] 691. Um, it was processed, reported on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] OK, do y'all send a remit out?
[AGENT][NEUTRAL] We send an EOB, yes, ma'am.
[CUSTOMER][NEUTRAL] State that
[CUSTOMER][NEUTRAL] An EOB? OK, what was the date of the EOB because we haven't received nothing yet.
[AGENT][NEUTRAL] Well, if you can give me your fax number, I'll send it to you.
[CUSTOMER][NEUTRAL] OK, yes, it's [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I get that fax ready for you and I'll be right back. Thank you, ma'am.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, thanks. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Come on computer.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, [PII]. I have that fax on its way to you now.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][POSITIVE] OK, thank you so much I appreciate it.
[AGENT][POSITIVE] It's no problem at all. Is there anything else I can help you with, Ms. [PII] before we go?
[CUSTOMER][NEUTRAL] Uh no, ma'am, that'll be it.
[AGENT][POSITIVE] OK, well, you have a wonderful.
[CUSTOMER][NEUTRAL] Uh, if I can get a reference number.
[AGENT][POSITIVE] Yes, you can use.
[CUSTOMER][NEUTRAL] Can I get a reference call reference?
[AGENT][NEUTRAL] Yes, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All right thank you so much I appreciate it.
[AGENT][POSITIVE] You're welcome you have a great weekend and thank you for calling APL.
[CUSTOMER][POSITIVE] OK thanks you too.
[AGENT][NEUTRAL] Mm, bye-bye.
[CUSTOMER][NEUTRAL] Mm bye bye.