AccountId: 011433970860
ContactId: a452f5e8-486d-42e7-a50d-23904067ae17
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 447559 ms
Total Talk Time (AGENT): 107700 ms
Total Talk Time (CUSTOMER): 163298 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/a452f5e8-486d-42e7-a50d-23904067ae17_20250423T16:12_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Thank you for calling SPL. This is. How may I help you?
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, could you please help me with the claim status?
[AGENT][NEUTRAL] Yes sir, I can help you with claim status. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah, my name is [PII].
[CUSTOMER][NEUTRAL] And I see
[AGENT][NEUTRAL] And what is your callback number please?
[CUSTOMER][NEUTRAL] Yeah, my, my callback number is [PII].
[CUSTOMER][NEUTRAL] And the extension number will be [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. And then can I please get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, the member's name is [PII] And the first name is [PII]
[CUSTOMER][NEUTRAL] And the date of birth is for this number that will be January.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEUTRAL] And the member member ID is for this member that will be.
[CUSTOMER][NEUTRAL] Yeah, the policy number is 02446503.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] You got the date of service.
[AGENT][NEUTRAL] Uh, yes, what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] That will be [PII].
[CUSTOMER][NEUTRAL] And the charge amount is 3467 $3,457.10 10.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] But I'm actually
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm, as per my system, the charge amount is 346,710, but let me check like previously BCBS Blue Cross Blue was processed this claim and they were paid for I think $618.21.
[CUSTOMER][NEUTRAL] And the left over the amount for $347.55.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEUTRAL] As special responsibility.
[AGENT][NEUTRAL] OK, and then what is the name of the facility you're calling from, [PII]?
[CUSTOMER][NEUTRAL] That will be your Robert Saint Francis Barkley Hospital.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look up this claim and I'll be right back with you.
[CUSTOMER][POSITIVE] Sure, not an issue. You just take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you so much for holding for me, [PII]. So looking on data service of uh [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I do not find the claim on file for that date of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Claim not found as per data service, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So what was the policy effective on term date?
[AGENT][NEUTRAL] The effective date is [PII] and the policy is still active.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. Can you provide me the mailing address to submit the claim?
[AGENT][NEUTRAL] Yes sir, the mailing address is [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes sir, and then the um zip code is [PII].
[CUSTOMER][NEUTRAL] Is there any pay ID?
[AGENT][NEUTRAL] Yes, payer ID is 60801.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 60801, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] What will be the call reference number?
[AGENT][NEUTRAL] The call reference number will be my name [PII] and today's date.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] What's, can you please repeat once again for me?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] You can use my name [PII]
[CUSTOMER][NEUTRAL] Your voice is cutting down, sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] OK, [PII], that's all for today from my side. Have a nice day.
[AGENT][POSITIVE] Well thank you have a great day also thank you for calling APL Sam.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] Bye-bye.