AccountId: 011433970860
ContactId: a70de618-7c9b-4c4a-ba04-6774e8995a92
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 507309 ms
Total Talk Time (AGENT): 136490 ms
Total Talk Time (CUSTOMER): 180115 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/a70de618-7c9b-4c4a-ba04-6774e8995a92_20250415T14:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, you said your name is [PII]?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Thank you [PII]. My name is [PII]. I'm calling from Jackson Memorial Hospital. Um, I'm calling to check, um, on the status of a claim for a patient.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with the claim. Can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, direct number is [PII].
[CUSTOMER][NEUTRAL] Um, [PII]. I'm sorry.
[AGENT][NEUTRAL] That's OK. All right, thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] I have.
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] It looks like the policy number they have is the payer ID which is weird.
[CUSTOMER][NEUTRAL] But I have a policy number of uh inpatient benefits cert number or outpatient benefit cert number OK 02501618 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Thank you very much. Let me pull that policy up real quick.
[AGENT][NEUTRAL] OK, and then can you please give me the date of service and the charge amount?
[CUSTOMER][NEUTRAL] So the first data service in question is [PII] 1225, uh, build amount is 22555.98.
[AGENT][NEUTRAL] Thank you. And then what is the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] So the insurance paid 99682 would a patient do a $427.18 so that's what we're expecting from you all.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on a brief hold while I look up this claim for us and I'll be right back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] All right, thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you so much for holding for me, Ms. [PII]. So looking on data service of [PII], I do not find a claim on file at this time.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, do you have any claims on file because I also have 33 and I think I found why it looks like, as I stated they added the payer ID which is 60801. Am I correct?
[AGENT][NEUTRAL] Yes, that is the payer ID number. What was the next date of service?
[CUSTOMER][NEUTRAL] 3325.
[AGENT][NEUTRAL] 3325.
[CUSTOMER][NEUTRAL] Should have been for 5:34. I'm sorry, should have been for 35431.
[AGENT][NEUTRAL] 354 31. Let me look real quick.
[AGENT][NEUTRAL] No, I'm not showing one for 33 of 25 either. Um, let me look and see.
[CUSTOMER][NEUTRAL] Let me try one more thing. What about 2:18?
[AGENT][NEUTRAL] 218 of 25.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, and then what was the amount for that one?
[CUSTOMER][NEUTRAL] Uh oh, I just lost it hold on.
[AGENT][POSITIVE] Oh, that's OK. Take your time.
[CUSTOMER][NEUTRAL] What did I? I have another one. It's OK. I have 2 525. 0 no, that's Blue Cross. Hold on.
[CUSTOMER][NEUTRAL] 2525413309.
[AGENT][NEUTRAL] 2252513301.
[CUSTOMER][NEUTRAL] No, 2525.
[AGENT][NEUTRAL] 205. OK, let me look.
[CUSTOMER][NEUTRAL] 2525 mhm.
[AGENT][NEUTRAL] OK, 25 of 2025 is not showing up either.
[AGENT][NEUTRAL] And, and that's all for [PII], right?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] mhm so I see what the problem, so we have the, so the ID number for outpatient is the 02501618 ML8 and for inpatient is ML7 correct?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, and the payer ID you did confirm is the 60801 correct?
[AGENT][NEUTRAL] Yes ma'am, now I do have, let me see if this is you. I do have one for the uh data service of 21825. Did you give me that data service?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Let me check, hold on.
[CUSTOMER][NEUTRAL] 218 that's 26252.
[AGENT][NEGATIVE] No, that doesn't look right, no, that's not your facility, sorry.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, was it for 35431?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] No, OK, because we do have a claim that needs to get to you for the data service as well. OK, um, [PII], may I have a reference? Is your name [PII]?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Why and may I have the first initials of your last name?
[AGENT][NEUTRAL] It's A
[CUSTOMER][NEUTRAL] Thank you and is there a reference number for our call today?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name and today's date.
[CUSTOMER][POSITIVE] Uh [PII] perfect thank you so much.
[AGENT][POSITIVE] You're very welcome, Ms. [PII].
[CUSTOMER][NEUTRAL] Um, what is your, I'm sorry, one more question. What's your timely family?
[AGENT][NEUTRAL] We don't have one, so as long as the um policy was active on data service you can file at any time.
[CUSTOMER][NEUTRAL] No? OK.
[CUSTOMER][POSITIVE] Perfect thank you so much so you have a great day.
[AGENT][POSITIVE] You too, Ms. [PII]. You have a wonderful rest of your week and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye-bye.