AccountId: 011433970860
ContactId: a0e2c53d-fdf9-4da8-bc8b-a8ce3d3ac2a3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 697369 ms
Total Talk Time (AGENT): 125327 ms
Total Talk Time (CUSTOMER): 98564 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/a0e2c53d-fdf9-4da8-bc8b-a8ce3d3ac2a3_20250109T14:31_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is my calling from Flo's office.
[AGENT][NEUTRAL] I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] [PII], thank you.
[AGENT][NEUTRAL] And [PII], what is a good callback number please, sir?
[CUSTOMER][NEUTRAL] Uh, it's [PII] and it's a direct line.
[AGENT][POSITIVE] Thank you, [PII]. It would be my pleasure to assist you today. How can I help you, [PII]?
[CUSTOMER][NEUTRAL] Uh, checking on claims.
[AGENT][NEUTRAL] All right, I can help you with that claims information. What is the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh, it's 01914394. M as in Mike, L as in Lima, and S, uh sorry, M as in Mike, L as in Lima, and 7.
[AGENT][NEUTRAL] All right, thank you, [PII]. And what is the patient's name and date of birth, please, sir?
[CUSTOMER][NEUTRAL] It's uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. And what is the date of service or claim number?
[CUSTOMER][NEUTRAL] OK. The date of service is [PII] of [PII] and the total bill amount is $570 even. And the claim number for this one, just a minute.
[CUSTOMER][NEUTRAL] Uh, it's 352-419-2.
[AGENT][NEUTRAL] OK and is the facility name please sir?
[CUSTOMER][NEUTRAL] Uh, it's Holy Cross Medical Group.
[AGENT][NEUTRAL] All right, thank you, and I'm showing that that was that claim was denied as a duplicate?
[CUSTOMER][NEUTRAL] Yes, uh, so this, uh, when I get the original film status for this one.
[AGENT][POSITIVE] Absolutely. It would be my pleasure.
[CUSTOMER][NEUTRAL] Yeah, I have
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, go ahead.
[AGENT][NEUTRAL] OK, so the original claim.
[AGENT][NEUTRAL] Let me get that received date for you.
[AGENT][NEUTRAL] That claim was originally received on [PII].
[AGENT][NEUTRAL] And processed and.
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] I had that concern as well.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Like, uh, the claim which you are providing is for different invoice and for the different bill amount. And, uh, ours is, the bill amount is $570 even and it was submitted on uh.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]. So can you just send this claim back for?
[AGENT][NEUTRAL] Bear with me just one second, let me pull that claim up.
[CUSTOMER][POSITIVE] OK. Take your time.
[AGENT][NEUTRAL] I'm checking it looks like we received it several times, so.
[CUSTOMER][NEUTRAL] Mhm, yes, go ahead.
[CUSTOMER][NEUTRAL] Yeah, but, uh, that we're all for different, uh, I mean, the bill amounts, I guess.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So what I'm trying to do is just check each claim for you, so bear with me just one moment, see why they processed it as a duplicate.
[CUSTOMER][POSITIVE] Yes, sure. Take your time.
[AGENT][NEUTRAL] OK, [PII], if you will hold just one moment, let me put in a request that they review this claim.
[CUSTOMER][POSITIVE] Uh yes, sure. Take your time.
[AGENT][NEUTRAL] If you don't mind holding just one moment, I'll be right back with you. It'll take me just a moment, OK?
[CUSTOMER][POSITIVE] OK, sure. Take your time.
[AGENT][POSITIVE] Thank you. I'll put you on a brief hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII], thank you for your patience. I have put in a request for the review of claim number 352-4192 as you were stating this is not a duplicate claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And they will review that, uh, could take up to 7 to 10 business days.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you'll hold just one more moment and let me complete this for you, OK?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] [PII], thank you. I have completed that request for you.
[CUSTOMER][NEUTRAL] OK. Can I get a reference number, please?
[AGENT][NEUTRAL] Call reference number is my name and today's date, and I spell my name, [PII] last [PII].
[AGENT][POSITIVE] And it's been a pleasure to assist you with that claim status. Anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Uh, oh, thank you so much, [PII], for resolving all my service. Have a great day.
[AGENT][POSITIVE] I hope you have a wonderful day as well. Like, thank you for calling APL and take care.