AccountId: 011433970860
ContactId: ada1316b-6743-4883-bada-97ff01c15109
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 494700 ms
Total Talk Time (AGENT): 147073 ms
Total Talk Time (CUSTOMER): 111277 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/ada1316b-6743-4883-bada-97ff01c15109_20250505T19:50_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, uh, [PII]. My first name is [PII]. My last name is [PII] calling you from the provider's office looking for claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] Uh, yes, the correct number, [PII].
[AGENT][NEUTRAL] Thank you and how many claims [PII] do you have to check status on?
[CUSTOMER][NEUTRAL] Uh, I have just only 2 queens.
[AGENT][NEUTRAL] Is it for the same patient or one data service for two different patients?
[CUSTOMER][NEUTRAL] Two different patients
[AGENT][NEUTRAL] OK, so you will use my I can help you with both and you will use my name that I gave you along with today's date as your call reference number for each one. Also, any information that I provide for you will be a verification of benefits and not a guarantee of payment. And lastly, if we do have the claims on file and you need a copy of the explanation of benefits, you may print them once you have the claim number by going to our portal.
[AGENT][NEUTRAL] And our portal website is located at [PII].
[AGENT][NEUTRAL] And what is your first patient's policy number?
[CUSTOMER][NEUTRAL] Yes, the patient that is.
[CUSTOMER][NEUTRAL] 02173249.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And what is your patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, the patient's first name is uh [PII], last name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] [PII]. Total charge is $33,962.88.
[AGENT][NEUTRAL] OK, so that was $[PII] for $33,962.88 is that correct?
[CUSTOMER][NEUTRAL] Yes, $33,962.88.
[AGENT][NEUTRAL] Mhm, yes, so that's what I have. So one moment.
[AGENT][NEUTRAL] And what is the name of the facility you're calling on behalf of?
[CUSTOMER][NEUTRAL] Uh, regional, OK, just hold on. Memorial Regional Medical Center Monsignor.
[AGENT][NEUTRAL] I haven't located it yet, but I'm still checking a couple, just a moment.
[AGENT][NEUTRAL] OK, so we have not received a claim for the facility for the dates of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And when you do submit the claim to us for review, [PII], we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] Can I have the number?
[CUSTOMER][NEUTRAL] OK. And how about the member effective date?
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] This policy has an effective date of [PII].
[CUSTOMER][NEUTRAL] OK, and the timely filing limit.
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] OK, thank you. Let's move to the next question.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Under the same PI.
[AGENT][NEUTRAL] And the next number's policy number?
[CUSTOMER][NEUTRAL] Uh, yes, the vision that is.
[CUSTOMER][NEUTRAL] Patient's ID 021-73249.
[AGENT][NEUTRAL] OK, that's the same one you just gave me.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] 24
[CUSTOMER][NEUTRAL] OK, OK. Actually, you know, I thought that that this is different patients, but yes, it is uh for the same patient.
[AGENT][NEUTRAL] OK, what is the data service and total bill amount?
[CUSTOMER][NEUTRAL] Uh, the data services.
[CUSTOMER][NEUTRAL] Uh, [PII] total charge is $7,386 even.
[AGENT][NEUTRAL] OK, again, that was for $616 for $7,386. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and there is also no claim on file for that data service.
[CUSTOMER][NEUTRAL] Uh, and you're saying that the call reference number would be?
[AGENT][NEUTRAL] And then this will also require?
[AGENT][NEUTRAL] Is my name in today's date and this one will also need to have the primary explanation of benefits sent along with the claim.
[CUSTOMER][POSITIVE] OK. Uh, thank you. That's all I need for today. I have a very blessed day.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, [PII]. Well, thank you for calling APL and if that's all I can help you with, I hope you have a nice day as well.
[CUSTOMER][POSITIVE] Uh, thank you, bye.
[AGENT][POSITIVE] OK. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Mm.