AccountId: 011433970860
ContactId: 93f34373-29e3-4675-b64f-ae0f1d8c3fbc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 609239 ms
Total Talk Time (AGENT): 154236 ms
Total Talk Time (CUSTOMER): 189121 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/93f34373-29e3-4675-b64f-ae0f1d8c3fbc_20250414T20:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Some is regarding the claim.
[AGENT][NEUTRAL] OK, I can help you with claim status. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Uh, yes, one second. The callback number would be [PII] and the extension would be [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get your first name?
[AGENT][NEUTRAL] Yes, it's [PII]
[AGENT][NEUTRAL] And can you spell your first name for me, please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] That is [PII] And the last name initially would be
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] And the, the member name is
[CUSTOMER][NEUTRAL] [PII] [PII] [PII], sorry, [PII]. And the date of birth is [PII]. And the policy number would be 01611741 M for Mary, L for Lucy, and number 8.
[AGENT][NEUTRAL] OK, let me look up that policy real quick so I can get you claim status.
[AGENT][NEUTRAL] OK, and then what is the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That is, uh, data service would be [PII] and the bill amount would be $82323.
[AGENT][NEUTRAL] OK, and then what's the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] What is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] That would be, that would be 58.49.
[CUSTOMER][NEUTRAL] Dollars.
[AGENT][NEUTRAL] OK, and thank you. And then can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] One second.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] One second.
[AGENT][POSITIVE] Yes sir, take your time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I.
[CUSTOMER][NEUTRAL] And the facility name would be
[CUSTOMER][NEUTRAL] Comprehensive pathology of comprehensive pathology associate.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes I can hear you and that was the first name uh before radiology Associates was the first name?
[CUSTOMER][NEUTRAL] That is comprehensive pathology associate.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on a quick hold while I look up this claim for us, [PII], and I'll be right back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, [PII]. So looking on data service of [PII], I do not find a claim on file for the amounts that you have given.
[CUSTOMER][POSITIVE] The bill whole bill amount is quickly verify with the whole bill amount.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, I do not find a claim on file.
[CUSTOMER][NEUTRAL] Could you please verify with this uh whole bill amount as primary $8823.
[AGENT][NEUTRAL] Yes, you gave me the billed amount of $823 and then after primary page you gave me the amount of $58.49.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] uh claim not on file?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Is this claim not?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Could you please verify the mailing address for this one?
[AGENT][NEUTRAL] Yes, um, you'll send it to [PII].
[AGENT][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] That's in [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Sorry, if you don't mind, could you please once repeat the [PII] address?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sorry. Could you please go to [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the city [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] One minute.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] And uh this uh status?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] City and state.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] What is the state would be?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the city would be?
[AGENT][NEUTRAL] [PII] City.
[CUSTOMER][NEUTRAL] City and state would be same only.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]. OK. And the ZIP code would be?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK. And the timely filing limit for this one?
[AGENT][NEUTRAL] We do not have one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No TFL.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And will this insurance uh accept to pay claim as well?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Could you please verify that the patient is active for the data service or not?
[AGENT][NEUTRAL] Yes, the policy effective date is [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And the policy is active and current.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Could you please provide me the reference number for this call?
[AGENT][NEUTRAL] Provide what, sir?
[CUSTOMER][NEUTRAL] It's a call reference number for?
[AGENT][NEUTRAL] Yes, you can use my name, [PII], in today's date.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Thank you. Uh, today's date and today's, uh, your name and today's date.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] That is [PII]
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you for helping out this claim. Have a good day. Bye for now.
[AGENT][POSITIVE] You you too [PII] thank you for calling APL you have a wonderful week.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] Thank you. Thank you so much. Bye-bye.
[AGENT][POSITIVE] You're welcome.