AccountId: 011433970860
ContactId: ade14b67-3493-4036-8edb-6e2f00dc3e1b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 358640 ms
Total Talk Time (AGENT): 101044 ms
Total Talk Time (CUSTOMER): 150415 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/ade14b67-3493-4036-8edb-6e2f00dc3e1b_20250502T17:18_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, good morning. My name is [PII] and I'm calling on behalf of the facility about discussing the claim. And can you please spell your good name for me?
[AGENT][NEUTRAL] Uh my name is [PII]. It's [PII]
[CUSTOMER][POSITIVE] Thank you so much, [PII]. How are you doing today?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][POSITIVE] I'm also doing well. Thank you so much for asking.
[AGENT][NEUTRAL] And you were needing claim status, is that right, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and do you have a good callback number?
[CUSTOMER][NEUTRAL] Uh, it is [PII] and it is a direct line.
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Uh, it is starting with 02150219 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] And the full name of the patient is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And then you have the date of service and bill charges?
[CUSTOMER][NEUTRAL] Sure. The date of service for this patient is [PII] and the total charge amount is $1,093.27.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Looks like
[AGENT][NEUTRAL] So we received that claim on 10-7-2024.
[AGENT][NEUTRAL] Process [PII] 9 2024.
[AGENT][NEUTRAL] He made a payment of 13669.
[CUSTOMER][NEUTRAL] And what was the allowed amount?
[AGENT][NEUTRAL] Um, this is a secondary policy, so we just, we just pay according to the policy. It's not like a PPO plan or HMO.
[AGENT][NEUTRAL] We paid one
[CUSTOMER][NEUTRAL] OK, no problem. And, uh, is there any is there any, uh, patient responsibility?
[AGENT][NEUTRAL] Um, again, we're, it's just a secondary policy, so we don't determine patient responsibility.
[CUSTOMER][NEUTRAL] OK. So, uh, the claim was processed on [PII] and the paid amount is $136.69 right?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And uh there is no information showing uh like uh the payment mode, uh, either the payment done via check or the EFT.
[AGENT][NEUTRAL] Yes, it's a single check.
[CUSTOMER][NEUTRAL] And can you please help me with the check number?
[AGENT][NEUTRAL] 2006961
[CUSTOMER][NEUTRAL] And can you please help me the uh issue date for the check?
[AGENT][NEUTRAL] Um, it is
[AGENT][NEUTRAL] In [PII].
[CUSTOMER][NEUTRAL] And can you please help me with a clear date?
[AGENT][NEUTRAL] Um, that, that was the pay date.
[AGENT][NEGATIVE] an issue.
[AGENT][NEUTRAL] Same date
[CUSTOMER][NEUTRAL] OK. So the claim uh that check was issued on the same date and they cleared on uh also the same date, right?
[AGENT][NEUTRAL] OK, the clear date is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, just allow me a moment. Uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you please verify the uh pay to address as well, that is [PII] [PII].
[AGENT][NEUTRAL] Um, no, it was sent to [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And can you please uh spell the city name one more time for me?
[AGENT][NEUTRAL] The city name is [PII].
[CUSTOMER][NEUTRAL] Oh, [PII]. OK.
[CUSTOMER][NEUTRAL] And uh can you please fax the UV on my fax number?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] What's your facts?
[CUSTOMER][NEUTRAL] Uh it is 510477-2438. And attention to my name, that is [PII]
[AGENT][NEUTRAL] OK, I'll get that faxed over. Just takes about 5 minutes.
[CUSTOMER][POSITIVE] OK, sure. Thank you so much, um, uh, [PII], and can you please help me with the card reference number now?
[AGENT][NEUTRAL] A call reference number is my name, [PII], and today's date.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Have a very wonderful day and have a very um happy weekend to you. Thank you for assisting me today. Bye-bye.
[AGENT][POSITIVE] Thank you for calling APL. You too. Bye-bye.