AccountId: 011433970860
ContactId: a8ae7743-fa32-42a9-82d6-c6963a3a2eb6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266540 ms
Total Talk Time (AGENT): 88380 ms
Total Talk Time (CUSTOMER): 115637 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/a8ae7743-fa32-42a9-82d6-c6963a3a2eb6_20250124T16:54_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] with about the family practice, and I'm checking in on a claim.
[AGENT][POSITIVE] It would be my pleasure to assist you. You said your name is [PII]?
[CUSTOMER][NEUTRAL] [PII], yep, what's about the family practice.
[AGENT][POSITIVE] Thank you, Ay. And what is a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the policy number please, ma'am.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 025052777
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Take it's [PII]
[AGENT][NEUTRAL] Hadn't seen that one before.
[CUSTOMER][NEUTRAL] I mean
[CUSTOMER][NEUTRAL] What did you say?
[AGENT][NEUTRAL] I have not seen that name before.
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. And you're needing eligibility?
[CUSTOMER][NEUTRAL] And I am checking on the claim status for a certain date which is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the total charge is 203.
[AGENT][POSITIVE] All right, then I'll be happy to help you with that claim status.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Well, it looks like we have received that claim 4 times. What's the facility name again if you don't mind?
[CUSTOMER][NEUTRAL] Sabetha Family Practice or Great Plains of Sabetha.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you. We do have to be the family practice.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] So let me get you, I can give you all the duplicate claim numbers as well, but the original claim we received on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] It was processed on [PII] and it was denied.
[AGENT][NEUTRAL] And the denial reason was our records indicate that premium for that data service was not received, therefore benefits are not payable. Actually, the policy termed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 24.
[CUSTOMER][NEUTRAL] Oh, OK, and then this was on [PII]. OK, that is what I need to know, so I will put this as patient responsibility then.
[AGENT][POSITIVE] It's my pleasure. Would you like that claim number?
[CUSTOMER][NEUTRAL] Um, sure, yep.
[AGENT][NEUTRAL] The claim number is 349.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 8686.
[CUSTOMER][POSITIVE] 8349-8686 perfect and it and it was.
[CUSTOMER][NEUTRAL] Term you said on [PII] perfect OK and hang on a second while I have you on the phone, I think there's a multi plan I was calling about. Let's see here.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Sorry, just have you on the phone here, I have, let me check one more thing here.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] You know, actually this might be with.
[CUSTOMER][NEUTRAL] I think it's under a multi plan.
[CUSTOMER][NEUTRAL] You know what, can you check this one and you can tell me if you can check this or not?
[AGENT][NEUTRAL] Sure. What's that number?
[CUSTOMER][NEUTRAL] Uh, OK, it's a different patient.
[CUSTOMER][NEUTRAL] The member number is.
[CUSTOMER][NEUTRAL] 683-088-542
[AGENT][NEUTRAL] Yeah, that's not gonna be our policy number.
[CUSTOMER][POSITIVE] That's not yours, OK, OK, because it was under a multi-plan, but then there's another plan name, so I just didn't know. OK, but thanks for helping me on the other one, and I will put that to face your responsibility then. Thanks for your help.
[AGENT][POSITIVE] Well, it's been my pleasure to assist you with the claim status. I do thank you for calling APL. Hope you have a great weekend.
[CUSTOMER][POSITIVE] Thanks you too bye.
[AGENT][POSITIVE] Thank you. Take care. Bye-bye.