AccountId: 011433970860
ContactId: aea53929-afa5-4401-91bc-727582f45747
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2136320 ms
Total Talk Time (AGENT): 336042 ms
Total Talk Time (CUSTOMER): 259388 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=-1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/aea53929-afa5-4401-91bc-727582f45747_20250428T20:33_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Your name is [PII], right?
[AGENT][NEUTRAL] I'm sorry, I, um, I couldn't hear you. Can you repeat?
[CUSTOMER][NEUTRAL] Yes, is it OK now?
[CUSTOMER][NEUTRAL] Actually, your voice is in and out.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Your voice is in and out. I cannot hear you well. Can you uh give me your name?
[CUSTOMER][NEUTRAL] I'm [PII].
[AGENT][NEUTRAL] How do you spell that?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Thank you and what's the callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] OK. And you're calling to get what type of information?
[CUSTOMER][NEUTRAL] I'm calling about claim status.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status. And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] That's Holy Cross Hospital for.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK. And what's the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, patient's policy number, that's 01221549 MS.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh, my first name gonna [PII] and last name gonna be [PII].
[AGENT][NEUTRAL] What's the date of birth?
[CUSTOMER][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] OK. What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Date of service that [PII].
[AGENT][NEUTRAL] OK. And how much is the total charge?
[CUSTOMER][NEUTRAL] Total charge $16,328.20.
[AGENT][NEUTRAL] $16,328.15.
[CUSTOMER][NEUTRAL] No, and 20 cents.
[AGENT][NEUTRAL] 2. OK. Let me see if I can find this claim for you and for future, you can check claim status online through our website at [PII].
[AGENT][NEUTRAL] And bear with me just a second.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so it was processed twice. Let me pull the original claim. OK, one moment.
[AGENT][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so it looks like we processed the claim originally on [PII].
[AGENT][NEUTRAL] And we send a benefit amount of $700 to the provider.
[CUSTOMER][NEUTRAL] Uh, you mean, uh, claim was paid, right?
[AGENT][NEUTRAL] I'm sorry, can you repeat?
[CUSTOMER][NEUTRAL] Um, you're saying that, uh, claim was paid, right?
[AGENT][POSITIVE] Correct, it was paid. Mhm.
[CUSTOMER][NEUTRAL] OK. Uh,
[CUSTOMER][NEUTRAL] OK, what is the amount?
[AGENT][NEUTRAL] 700.
[CUSTOMER][NEUTRAL] $700.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] Um, what is the pay date?
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] Mhm. Uh, can you please provide, is this check or AFT?
[AGENT][NEUTRAL] This is a check, a single check, a paper check?
[CUSTOMER][NEUTRAL] Can you please forward me check number?
[AGENT][NEUTRAL] Yes, the check number is 2027156.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you please clarify that uh check address, I mean, verify the check address is Holy Cross Hospital [PII].
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] OK, um, the check, the payment has been made to Hollow Cross Hospital.
[AGENT][NEUTRAL] And that is [PII].
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Uh, no, that's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, let me check the claim.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, bear with me, let me review this claim really quick. Do you mind holding for me?
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][POSITIVE] Thank
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Ms. [PII]. OK, I'm working on getting this reprocessed, so it's gonna take me a few more minutes. I'm just trying to send it to the correct department, OK? So bear with me on the line so I can send this over, OK? One moment.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][POSITIVE] Thank thank you.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me.
[AGENT][NEUTRAL] Is there [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I went ahead and send the request for the check to be canceled and reissued, OK? To the correct address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Yes, yes. Um, one moment, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, what is the tax for that, uh, you should check?
[AGENT][NEUTRAL] The what? I'm sorry?
[CUSTOMER][NEUTRAL] Uh, I mean, what is the time, uh,
[AGENT][NEUTRAL] The time frame for the reprocess of the claim?
[CUSTOMER][NEUTRAL] That what.
[AGENT][NEUTRAL] It's gonna be 24 to 48 business hours.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] 48 business hours. OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, then.
[CUSTOMER][NEUTRAL] Can you please forward me claim number?
[AGENT][NEUTRAL] The claim number, uh, let me pull it up again. That is 3561789.
[CUSTOMER][NEUTRAL] Actually, I have another claim. Can you please help me for that claim, please?
[AGENT][NEUTRAL] Is it gonna be the same member or a different member?
[CUSTOMER][NEUTRAL] Uh, different number but same provider.
[AGENT][NEUTRAL] OK, give me just a minute. I'll have to notate this one. So you don't need any other information on this one?
[CUSTOMER][NEUTRAL] Uh, nothing. Can you please provide me call difference for this client?
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's date.
[CUSTOMER][NEUTRAL] Sure. Uh.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, I know.
[AGENT][NEUTRAL] That number.
[AGENT][NEUTRAL] I and the.
[AGENT][NEUTRAL] OK. All right. Um, what is the next policy number?
[CUSTOMER][NEUTRAL] Uh, that's 02413470 M as Mary, L as Lima, 8.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Member first name gonna be [PII] and last name gonna be White.
[AGENT][NEUTRAL] OK, what's the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] to turn 24.
[CUSTOMER][POSITIVE] And total premium.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Can you repeat the date of er um the date of service.
[CUSTOMER][NEUTRAL] Uh, data service that [PII].
[AGENT][NEUTRAL] OK, [PII]. OK, thank you. And what is the amount?
[CUSTOMER][NEUTRAL] Uh, that's $5,326 even.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] OK, let me pull the.
[AGENT][NEUTRAL] OK, so this one was processed on [PII] and we send a benefit amount of $290.97. And with the payment of that check, the maximum has been exhausted for the calendar year.
[CUSTOMER][NEUTRAL] Uh, I'm sorry. Can you please, uh,
[CUSTOMER][NEUTRAL] Say no, because I'm documenting here. Uh, [PII] is passing that, right?
[AGENT][NEUTRAL] Yes, [PII] is when we process the claim.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Did you pay this, uh,
[AGENT][NEUTRAL] We send a check. Yes, we send a check. The check amount is for $290.97.
[CUSTOMER][NEUTRAL] You pay for this one?
[AGENT][NEUTRAL] And with the payment of that check.
[CUSTOMER][NEUTRAL] OK. Uh.
[AGENT][NEUTRAL] The with the payment of that check, the policy maximum has been exhausted for the year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The policy max allowed, uh, what's next?
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yes, it has been Max.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] For the year
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Can you please provide me pay date?
[AGENT][NEUTRAL] Is the same as the process date [PII]?
[AGENT][NEUTRAL] Now, the day that the check cleared is different. Do you need the check clear date?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. The check clear date is [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, can you please provide me check number?
[AGENT][NEUTRAL] Yes, the check number is 2013347.
[CUSTOMER][NEUTRAL] Uh, is this single by check or or check?
[AGENT][NEUTRAL] This is a single check, paper check?
[CUSTOMER][NEUTRAL] Uh, can you please verify, uh,
[CUSTOMER][NEUTRAL] Check address.
[AGENT][NEUTRAL] Yes, the address on this one is [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Then, can you please provide me the claim number?
[AGENT][NEUTRAL] OK, the claim number on this one is 3529313.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes, yes, I'm still here. Um, OK, then. Uh, can you please, uh, fax to the UP?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, what is the fax number?
[CUSTOMER][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] 2452. OK, so that is [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and how do you spell your name again? Is it gonna be to your attention?
[CUSTOMER][NEUTRAL] Uh, that's my name, [PII].
[AGENT][NEUTRAL] OK, how do you spell your name again?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] OK. Um, do you mind holding for me while I send this out to you right now?
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me. Yeah, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, nothing. Can you please spell your name for me? One second.
[AGENT][NEUTRAL] Sure. Mhm.
[AGENT][NEUTRAL] Let me know when you're ready.
[CUSTOMER][POSITIVE] Yes, I'm ready.
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a, yes, yes.
[CUSTOMER][NEUTRAL] And, and.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. Thank you. Have a nice day.
[AGENT][POSITIVE] Yes as well. Is there anything else I can help you with today?
[CUSTOMER][NEGATIVE] I'm nothing. I'm done for today.
[AGENT][POSITIVE] OK. Thank you for calling APL. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah, bye bye.
[AGENT][NEUTRAL] Bye.