AccountId: 011433970860
ContactId: 9626d0d8-887e-4f96-a07d-f0525b18475f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194270 ms
Total Talk Time (AGENT): 76342 ms
Total Talk Time (CUSTOMER): 66715 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/9626d0d8-887e-4f96-a07d-f0525b18475f_20250409T12:30_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good morning. I'm sorry, this is who?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I have a question about a claim.
[AGENT][NEUTRAL] Sure, [PII], I could assist you with that.
[AGENT][NEUTRAL] Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] [PII] and it's a direct line and the member's policy number is 02496781.
[AGENT][NEUTRAL] And [PII], you're calling from a doctor's office?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Could you verify the name of the facility and the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Holy Cross Medical Group and the patient is [PII], [PII].
[AGENT][NEUTRAL] [PII], what is the date of service that you're calling to check the status of?
[CUSTOMER][NEUTRAL] [PII] of this year, the total bill amount was $4,436.
[AGENT][NEUTRAL] A facility charge?
[CUSTOMER][POSITIVE] No, this is professional.
[AGENT][NEUTRAL] What is your procedure code?
[CUSTOMER][NEUTRAL] 936556.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] 2656
[AGENT][NEUTRAL] So it looks like this claim is currently pending.
[AGENT][NEUTRAL] And there's nothing that you have to do or the insured we're just waiting on verification of eligibility.
[CUSTOMER][NEUTRAL] OK, and
[AGENT][NEUTRAL] Once we receive it, then the benefits will be released.
[AGENT][NEUTRAL] If benefits are owed.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, verification of eligibility for the patient.
[AGENT][NEUTRAL] No, for not, it has nothing to do with you nor the patient we have to get the eligibility from the employer, the associate the group.
[AGENT][NEUTRAL] In regards to eligibility for the patient.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Got it. All right. So, um, do you know what the turnaround time is that?
[AGENT][NEUTRAL] I'm not sure, let me see when this claim was processed.
[AGENT][NEUTRAL] Um, this claim was processed [PII], so um.
[AGENT][NEUTRAL] Once we receive that information, it it normally takes about roughly 30 days, however, I'm not sure.
[AGENT][NEGATIVE] I don't want to give you a time frame then it's not accurate.
[CUSTOMER][NEUTRAL] Right, and I'm just saying I'm just like an estimate. I'm not holding right, right, I'm just not I'm not gonna hold you to it 30 days won't happen, I get it. So just an average of what it generally is, that's fine. Um, so I'll follow up and maybe about, yeah, I'll follow up and maybe another 2 weeks.
[AGENT][NEUTRAL] Yes, 30 days.
[AGENT][NEUTRAL] Alright, is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] I was a child. I just need a reference number.
[AGENT][NEUTRAL] We don't provide those, but you can use my name in today's date as a reference.
[CUSTOMER][POSITIVE] Perfect. And it's [PII]?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Perfect. You have a good one, enjoy the rest of your day.
[AGENT][POSITIVE] Thanks for calling APL. You have a great one as well, [PII]. Goodbye.
[CUSTOMER][NEUTRAL] Uh