AccountId: 011433970860
ContactId: 97fcb100-9449-463e-8979-0a175eca5cb2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226429 ms
Total Talk Time (AGENT): 65250 ms
Total Talk Time (CUSTOMER): 93297 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/97fcb100-9449-463e-8979-0a175eca5cb2_20250508T16:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. This is [PII] calling from provider Hope regarding the claim status.
[AGENT][POSITIVE] All right. I'm happy to check on a claim for you. What's the policy number?
[CUSTOMER][NEUTRAL] Mind you, the policy number is
[CUSTOMER][NEUTRAL] 237 2
[CUSTOMER][NEUTRAL] 853.
[AGENT][NEUTRAL] And may I please have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, sure. The patient's name is?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, data service.
[CUSTOMER][NEUTRAL] The date of services?
[CUSTOMER][NEUTRAL] One second, please. The date of services um [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you. And the bill amount?
[CUSTOMER][NEUTRAL] The bill amount is $676.
[AGENT][NEUTRAL] So we don't have any claims on file for a billed amount of $676.
[CUSTOMER][NEUTRAL] Actually, uh, the claim has been initially billed to Cigna. Uh, Cigna has been paid partially and the claim has been moved to your insurance as patient's deductible.
[CUSTOMER][NEUTRAL] So I'm just calling to verify.
[AGENT][NEUTRAL] Obviously
[AGENT][NEUTRAL] Do you have a different amount after the primary paid than the 676?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes. Yes, I'm having a different amount. The different amount is $52.52 dollars 2 cents.
[AGENT][NEUTRAL] All right, so yeah, it doesn't look like we have any claims on file for that amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes. Have you found any claim?
[AGENT][NEUTRAL] There's no claim on file.
[CUSTOMER][NEUTRAL] OK. Uh, can you check if the patient is active for the rate of service?
[AGENT][NEUTRAL] Yes, they are. Policy effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Still active.
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] Uh, can you help me with one thing that your insurance is gonna pay patient's deductible amount?
[AGENT][NEUTRAL] Or the secondary insurance. So this does cover deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK. Uh, the primary has transferred the allowed amount as deductible. The Cigna has transferred. That amount has been transferred to your insurance.
[AGENT][NEUTRAL] There's no claim we don't show any claims on file. It just needs to be sent to us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I got it. Can you help me with your name?
[AGENT][NEUTRAL] My name is [PII], that's [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] OK. Can I get the call reference number?
[AGENT][NEUTRAL] Call references my name with today's date.
[CUSTOMER][NEUTRAL] OK. I was competing with your initial last name too with your date. That's it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. Have a wonderful day. Nice talking with you.
[AGENT][NEUTRAL] You as well bye bye.