AccountId: 011433970860
ContactId: a3f9b62a-7772-43b5-9c77-80e2c65255aa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 631270 ms
Total Talk Time (AGENT): 127836 ms
Total Talk Time (CUSTOMER): 107779 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/a3f9b62a-7772-43b5-9c77-80e2c65255aa_20250414T15:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], my name is [PII]. I'm calling from Northwest Hospital, and I'm calling on claims or bill status, please.
[AGENT][NEUTRAL] Yes, fine. I can help you with claims today.
[AGENT][NEUTRAL] Do you have the policy number on you?
[CUSTOMER][NEUTRAL] 02518304
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, perfect. And the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then do you have a data service or a charge amount?
[CUSTOMER][NEUTRAL] Data service 827 through 91 of 24.
[CUSTOMER][NEUTRAL] In the amount of $285,432.
[AGENT][NEUTRAL] OK, can you repeat that for me? Sorry. 8:27.
[CUSTOMER][POSITIVE] No, that's all right.
[CUSTOMER][NEUTRAL] True.
[CUSTOMER][NEUTRAL] 91 of 24.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $285,432.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] It's Monday and I ask for people to repeat things all the time.
[AGENT][NEUTRAL] Yes, uh, it is a Monday.
[AGENT][NEUTRAL] OK. And this is a hospital charge?
[CUSTOMER][NEUTRAL] It is.
[AGENT][NEUTRAL] Is that correct? OK.
[CUSTOMER][NEUTRAL] Northwest Hospital.
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] Sorry, I'm looking at all of these claims really quick.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hey, are you still there?
[CUSTOMER][NEUTRAL] I am.
[AGENT][NEUTRAL] Oh, OK. It was just like really silent, um.
[AGENT][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] I know I had it on mute. I always mute it when you guys are working.
[AGENT][NEUTRAL] 00, I see.
[AGENT][POSITIVE] Oh thank you we appreciate it.
[AGENT][NEGATIVE] OK, so it looks like for this claim, it was denied. It says insured's primary insurance provided full benefits. There are no benefits payable.
[CUSTOMER][NEUTRAL] OK, let's see here what is their primary?
[AGENT][NEUTRAL] And then I can also provide you with that claim number if you need it.
[CUSTOMER][NEUTRAL] Yeah, I do in just a second. OK, so you guys received the the original EOB of payment from Health Ease or Cigna PPO.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, correct. Mhm.
[CUSTOMER][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] And it was full payment from them.
[AGENT][NEUTRAL] Yes, it says primary insurance provided full benefits.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK, what day did you originally receive it, please?
[AGENT][NEUTRAL] Let's see, let me go back.
[AGENT][NEUTRAL] OK, so it looks like.
[AGENT][NEUTRAL] The received date was [PII].
[AGENT][NEUTRAL] And then the process date was [PII].
[CUSTOMER][NEUTRAL] Alright, so do you have a reference number for me?
[AGENT][NEUTRAL] I do. It is my first name, which is [PII]
[AGENT][NEUTRAL] Last initial [PII]
[AGENT][NEUTRAL] And then today's date.
[CUSTOMER][NEUTRAL] I can't believe we're already in the middle of April already.
[AGENT][NEGATIVE] I know, it is just flying by. It makes me sad.
[CUSTOMER][NEUTRAL] I understand, OK, um.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] You have a great day and thank you for the information.
[AGENT][NEUTRAL] Of course. Is there anything else I can help you with while I have you on the line?
[CUSTOMER][NEUTRAL] I don't think so. Oh, the claim number I have actually is 353-4703. Is that correct?
[AGENT][NEUTRAL] Yes, so the one that I was looking at is the most recent, which is 3558764.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So we've resubmitted it for reconsideration a couple times then.
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] [PII], have a great rest of your Monday.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Thank you. You too, [PII]. Thanks for calling APL. All right, bye.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Bye bye.