AccountId: 011433970860
ContactId: a27de051-a318-4832-bd2f-ae459d6ccf3c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 295100 ms
Total Talk Time (AGENT): 135004 ms
Total Talk Time (CUSTOMER): 87292 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/a27de051-a318-4832-bd2f-ae459d6ccf3c_20250207T19:38_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, yeah, I'm just calling in regards to a hospital plan.
[AGENT][POSITIVE] Well it would be my pleasure to assist you. Do you have your policy number available?
[CUSTOMER][NEUTRAL] Uh yeah, let's see.
[CUSTOMER][NEUTRAL] I am a provider.
[AGENT][NEUTRAL] Are you the provider?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Oh, what is your name? I'm sorry.
[CUSTOMER][NEUTRAL] Uh, let's see
[CUSTOMER][NEUTRAL] Uh, my name is [PII], and it's the last [PII].
[AGENT][NEUTRAL] Thank you and a callback number, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. OK, and if you have that patient's policy number.
[CUSTOMER][NEUTRAL] Yeah, I got a 023.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 88.
[CUSTOMER][NEUTRAL] 488
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] I'm looking at a Hubert
[CUSTOMER][NEUTRAL] Uh, media.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, thank you, and I can help you with that claim status. What is the date of service for it?
[CUSTOMER][NEUTRAL] Yeah, we're looking at 41 to 44 of this 202.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] 41 to 44 I mean.
[CUSTOMER][NEUTRAL] Oh, you know what, hold on one second, I lied, it's 83 2024.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the name of the facility and the build amount?
[CUSTOMER][NEUTRAL] We're looking at Ohio State University Medical Center.
[CUSTOMER][NEUTRAL] And it looks like this one's going to be for $2,609.
[AGENT][POSITIVE] All right, thank you, [PII].
[AGENT][NEUTRAL] And [PII], we did receive that claim on [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[AGENT][NEUTRAL] The claim was denied because the maximum benefit for that data service has been met.
[CUSTOMER][NEUTRAL] OK, uh.
[AGENT][NEUTRAL] This is a limited medical policy, not major medical.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And did you need that claim number, [PII]?
[CUSTOMER][NEUTRAL] So the, there would be.
[CUSTOMER][NEUTRAL] Uh, yeah, I'll need a bunch of stuff. Uh, so would this be patient's responsibility then?
[AGENT][NEUTRAL] So because we're not major medical, we don't determine patient responsibility, that will be determined by the provider. Are you a multi-plan provider?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] I'm not for sure.
[AGENT][NEUTRAL] If you are a multi plan provider they would be eligible for that multi plan discount but that is strictly through multi plan not APL there's no contractual involvement with our processing.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Yeah, I think we might do that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yes, so I'll need claim number.
[CUSTOMER][NEUTRAL] I guess that's all you're gonna be able to give me.
[AGENT][NEUTRAL] The claim number is 352.
[AGENT][NEUTRAL] 557 8
[AGENT][NEUTRAL] And that's the original claim number we did receive the claim again and processed it as a duplicate denied if you need that claim number I can provide that as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] No, no, we just go with this original one. are you able to send over that EOB? Uh, looks like it got lost.
[AGENT][NEUTRAL] I can
[AGENT][POSITIVE] Yeah, I can fax it to you or we have a provider portal. I can help you with that real quick and you'll have that EOB instantly if you would. I can help you with that.
[CUSTOMER][NEUTRAL] Well, actually one.
[CUSTOMER][POSITIVE] Never mind, I found it already. I'm just really good at my job, you see.
[AGENT][POSITIVE] Did you get it? Good.
[AGENT][POSITIVE] Yeah, you just ask for it and it appears, you're good.
[CUSTOMER][NEUTRAL] Uh, all right. Uh, what was your name again?
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] If you need a reference number, [PII], it would be my name and today's date.
[AGENT][NEUTRAL] Anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, no, I believe that'll be all. Thank you so much for your help.
[AGENT][POSITIVE] It's been my pleasure to assist you with that claim status, [PII]. Thank you for calling APL, and I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] OK.