AccountId: 011433970860
ContactId: a1488e80-f061-41a1-854f-8712c43b4ce7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 359519 ms
Total Talk Time (AGENT): 135666 ms
Total Talk Time (CUSTOMER): 105278 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/a1488e80-f061-41a1-854f-8712c43b4ce7_20250110T22:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm calling from the Court Institute calling regarding a claim for a patient.
[AGENT][NEUTRAL] OK, I can help you, Miss [PII] with the claim. What is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, and then what is [PII]'s policy number?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] 02249758 M as in Mary L7.
[AGENT][NEUTRAL] OK, thank you. And then um the date of service, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then what is the charge amount?
[CUSTOMER][NEUTRAL] $1740.68.
[AGENT][NEUTRAL] Thank you and then can you give me the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] $1,016.55.
[AGENT][NEUTRAL] Thank you. And then I know you mentioned it when I first answered the phone, but can you please give me the facility you're calling from again?
[CUSTOMER][NEUTRAL] The core institute.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, Miss [PII]. I'm gonna look up that claim for you and I will be right back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. You are on hold.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Hi Miss [PII], this is [PII] back with you again. So looking for data service of [PII] for.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] [PII], is that how you say it? Tande?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] I'm gonna go with Tande Tande, [PII].
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh. [PII].
[AGENT][NEUTRAL] Um, I do not find a claim on file for the amount that you have given me or from your facility.
[CUSTOMER][NEUTRAL] For Terrence, um, I'm, let me give you this claim number that I pulled up.
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] It is 341-457-2.
[AGENT][NEUTRAL] OK, I do see that claim, but it's not for that amount or for.
[AGENT][NEUTRAL] The facility that you gave me, it's for a different facility.
[CUSTOMER][NEUTRAL] It's not for the, the, the court institute?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] That's the EOB that I'm pulling up. Hold on one second. Let me pull it back up.
[AGENT][NEUTRAL] Would your, um, facility have multiple names, a different name?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Hoo
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh, the Center for Orthopedic Research and Education.
[AGENT][NEUTRAL] That's it, that's the one I have. OK, let me look it up real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's got two remarks on it. One is that office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] Huh.
[AGENT][NEUTRAL] Well, and then the second remark is pretty much the same thing. The service is not covered when performed in a doctor's office or clinic, so the insured's policy does not cover office visits.
[CUSTOMER][POSITIVE] Interesting.
[CUSTOMER][NEUTRAL] OK, so then is this.
[CUSTOMER][NEUTRAL] Become patient responsibility.
[AGENT][NEUTRAL] We don't give out patient responsibility, um, that's usually determined by the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK, and then you said your name is [PII]?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] You said is it [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Why, OK, and then the first letter to your last name?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] See, OK, alright, sounds good and then can I get a reference number for our call?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name and today's date.
[CUSTOMER][POSITIVE] OK, sounds good, that is all I need thank you for your help.
[AGENT][POSITIVE] You're so welcome. I hope you have a good weekend, [PII]. Thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you as well thank you bye bye.
[AGENT][NEUTRAL] Bye-bye, ma'am.