AccountId: 011433970860
ContactId: a72e6cba-c617-4a80-a437-3373c374166f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 396519 ms
Total Talk Time (AGENT): 103901 ms
Total Talk Time (CUSTOMER): 111968 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/a72e6cba-c617-4a80-a437-3373c374166f_20250509T15:07_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]. This is [PII] calling from Mercy Hospital, checking on a claim status.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with a claim status. May I please get your callback number?
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It's [PII] and date of birth is [PII].
[AGENT][NEUTRAL] And Ms. [PII]'s policy number, please?
[CUSTOMER][NEUTRAL] Uh, the policy number is gonna be 004236670.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, looking up policy number 004236670. I'm not finding a policy on file for her.
[AGENT][NEUTRAL] Do you see another number?
[CUSTOMER][NEUTRAL] Uh, it's just only uh 004236670.
[AGENT][NEUTRAL] OK. Do you um have her social?
[CUSTOMER][NEUTRAL] Yes, I do have the SSN number.
[AGENT][NEUTRAL] What is that, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what kind of claim is this please?
[CUSTOMER][NEUTRAL] It's a medical claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And may I please get her date of service?
[CUSTOMER][NEUTRAL] Date of service is gonna be [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so looking at her policies.
[AGENT][NEUTRAL] She does not have any medical coverage.
[AGENT][NEUTRAL] The last policy effective date um was [PII] and the policy terminated on [PII].
[CUSTOMER][NEUTRAL] OK, so you're stating that policy was effective from [PII] with um uh APL, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] And the member is not active for the detail service.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Um, just a moment. I'll just check once.
[CUSTOMER][NEUTRAL] So is the uh balance patient responsibility? Can we bill it to the patient?
[AGENT][NEUTRAL] We did
[AGENT][NEGATIVE] We do not give patient responsibility.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEGATIVE] We do not give patient responsibility.
[CUSTOMER][NEUTRAL] You're saying that we can't bill it to the patient?
[AGENT][NEUTRAL] I'm saying that we do not give out patient responsibility. We let the provider determine that.
[CUSTOMER][NEUTRAL] OK, just a moment.
[CUSTOMER][NEUTRAL] I'm just checking one.
[CUSTOMER][NEUTRAL] Um, as I check for the date of service, um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] She's saying that for the year of [PII], ma'am it doesn't have APL policy, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Is there any other insurance listed for the member as secondary?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK, may I know the last of digits CV?
[AGENT][NEUTRAL] The last what, please? Can you repeat that?
[CUSTOMER][NEUTRAL] coordination of benefits.
[AGENT][NEUTRAL] We do not do coordination of benefits.
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you so much for being online, patiently waiting.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] So, can you just
[CUSTOMER][NEUTRAL] Can you, uh, just provide me the call reference for the call?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name [PII], and today's date.
[CUSTOMER][NEUTRAL] OK, today's date, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK. Thank you so much for providing me this information, [PII]. That's it for now.
[AGENT][POSITIVE] You're very welcome. I hope you have a wonderful day, Ms. [PII], and thanks for calling APL.
[AGENT][NEUTRAL] Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] You too, bye for now. Bye.