AccountId: 011433970860
ContactId: a4144976-e481-47a3-83a6-2a01346c9df0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 729599 ms
Total Talk Time (AGENT): 178799 ms
Total Talk Time (CUSTOMER): 163715 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/a4144976-e481-47a3-83a6-2a01346c9df0_20250317T14:45_UTC.wav
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[AGENT][POSITIVE] Thank you for
[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Proto's office.
[AGENT][POSITIVE] Hi [PII] how are you today?
[CUSTOMER][POSITIVE] I'm doing good and how's your day going on?
[AGENT][POSITIVE] It's going good so far.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you for asking.
[CUSTOMER][NEUTRAL] We
[AGENT][POSITIVE] How can I help you today?
[CUSTOMER][NEUTRAL] I'm checking on claim status.
[AGENT][NEUTRAL] OK, I can help you with the claim status, sir. Can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Um, it's [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you sir and then what is um.
[AGENT][NEUTRAL] The patient's name, date of birth, and policy number.
[CUSTOMER][NEUTRAL] Um, yes, the stomach.
[CUSTOMER][NEUTRAL] OK, so the patient's ID is [PII].
[CUSTOMER][NEUTRAL] M [PII] in [PII], 8, and the patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, let me look that patient up real quick.
[AGENT][NEUTRAL] OK, and then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] Um, yes, for this one, I had one specific question as well, and the total charge is 930 of 2024 and the total bill amount is $661 even.
[CUSTOMER][NEUTRAL] And uh for this one, we had sent the claim via fax. So I just wanted to confirm if you guys have received it or not.
[AGENT][NEUTRAL] OK, I can look and you said that data service was [PII]?
[CUSTOMER][NEUTRAL] Um, yes, because initially while, uh, we had called yesterday, the claim was, I mean there is no claim on file, so then we had to go ahead and send this claim via fax so.
[AGENT][NEUTRAL] OK, alright, and you said the charge amount is $661. What is the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] OK, just give me a minute um.
[CUSTOMER][NEUTRAL] It's a total of um just give me uh.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] It's uh $91.91 remaining from the uh primary.
[AGENT][NEUTRAL] OK, and then what is the the facility?
[CUSTOMER][NEUTRAL] The name of the facility is Holy Cross Medical Group.
[AGENT][NEUTRAL] Holy Cross. OK, just to be clear, that was [PII].
[CUSTOMER][POSITIVE] Um, yes, you're right. Yes.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on a quick hold while I look up this.
[CUSTOMER][NEUTRAL] And the total bill was
[AGENT][NEUTRAL] $661 total.
[CUSTOMER][NEUTRAL] Mhm. So the total bill was?
[CUSTOMER][POSITIVE] Yes, you're right.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I'll be right back, [PII].
[CUSTOMER][NEUTRAL] Not me. You are on hold.
[AGENT][NEUTRAL] [PII], which day, what was the date that you sent in the fax?
[CUSTOMER][NEUTRAL] Um, it was sent on [PII].
[AGENT][NEUTRAL] OK, I do see that something did come through on [PII] and it's in progress, so I can't see any claims information on it yet. It takes 7 to 10 business days for it to process. So at this time we did receive something on [PII], but it's the process right now of being examined.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so what's the normal processing time?
[AGENT][NEUTRAL] 7 to 10 business days.
[CUSTOMER][NEUTRAL] I just.
[CUSTOMER][NEUTRAL] OK. So, can you help me with a different patient?
[AGENT][NEUTRAL] Yes, let me put my note in this one back.
[CUSTOMER][NEUTRAL] OK, so take your time. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, thank you for holding for me, [PII], we can move on to the next patient now.
[CUSTOMER][NEUTRAL] Mhm. So the next patient's uh member ID is 023 consecutive 5 and 046.
[AGENT][NEUTRAL] OK, let me pull that one up.
[AGENT][NEUTRAL] And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's so [PII], uh, it's [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK and then what is the data service in charge amount?
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII] and the total charge is $288 even. And um for this one as well, I had one specific question.
[AGENT][NEUTRAL] OK, and then can you please give me the charge amount after [PII] paid their part?
[CUSTOMER][NEUTRAL] OK, just give me a minute.
[CUSTOMER][NEUTRAL] It's uh $53.89.
[AGENT][NEUTRAL] OK and then what is the um name of the facility for this one?
[CUSTOMER][NEUTRAL] Right, same as the previous one, Holy Cross Medical Group.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look this one up.
[AGENT][NEUTRAL] OK, and what is the um question you had about this claim?
[CUSTOMER][NEUTRAL] Um, yes, for this one, we had, uh, submitted a W9 form. We have fax on [PII]. So I just wanted to check if you guys have received that one and if you guys have re
[CUSTOMER][NEUTRAL] And uh if you guys have received, can you just uh go ahead and reissue a new payment because it was uh initially paid to incorrect address.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see if it was paid.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so looking at this, I do see that a request has already been sent in to void the uh first payment and reissue payment so that's been taken care of, um, you should be getting the payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so how many days should I allow for that one?
[AGENT][NEUTRAL] Uh, again, 7 to 10 business days because they have to reprocess the whole claim again and t[PII] send the payment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so when did you guys have received the WA form for my documentation purpose?
[AGENT][NEUTRAL] Um, let me look.
[AGENT][NEUTRAL] Uh, looks like on [PII].
[CUSTOMER][NEUTRAL] OK, just a minute.
[CUSTOMER][NEUTRAL] Uh, it was on [PII], right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK then. Can I get a good conference number, please?
[AGENT][NEUTRAL] Yes sir, you can use my name [PII] in today's date.
[CUSTOMER][POSITIVE] Uh, OK then, thank you so much, [PII] for resolving all my ques. Have a good day.
[AGENT][POSITIVE] You too [PII] you have a blessed one thanks for calling APU.
[AGENT][NEUTRAL] Bye-bye, sir.
[CUSTOMER][POSITIVE] Definitely.