AccountId: 011433970860
ContactId: b08f496b-4847-465f-aef5-c8e23e31b622
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 340380 ms
Total Talk Time (AGENT): 106091 ms
Total Talk Time (CUSTOMER): 159508 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/b08f496b-4847-465f-aef5-c8e23e31b622_20250319T18:04_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, my name's [PII]. I'm calling from Lexington Medical Center's business office, and I need to check the status on the medical bill.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII], and what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh, D as in David 435-09695.
[AGENT][NEUTRAL] [PII], our policy numbers are all numerical, starting with a 0. Do you happen to have the policy certificate number for the patient?
[CUSTOMER][NEUTRAL] Um, let's see what I have here so we have that listed wrong and maybe um.
[CUSTOMER][NEUTRAL] Let me see
[CUSTOMER][NEUTRAL] I have a card here.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Do do do
[CUSTOMER][NEUTRAL] said it begins with um.
[AGENT][NEUTRAL] 0.
[CUSTOMER][NEUTRAL] A 0, let's see.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Oh it says employee ID. It starts with a D4.
[AGENT][NEUTRAL] And that is on a 90 degree benefit card or an IMA card?
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Um, the card that we have says TRC.
[AGENT][NEUTRAL] That's the group name TRC staffing.
[CUSTOMER][NEUTRAL] And it has multi client.
[AGENT][NEUTRAL] Yeah, OK, well, let's do a name search and see if they have medical coverage with APL. What is the patient's last name?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, [PII]
[AGENT][NEUTRAL] And first name please ma'am.
[CUSTOMER][NEUTRAL] Uh [PII]
[AGENT][NEUTRAL] And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And this is for, you're calling for medical?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Claim status? OK.
[AGENT][NEUTRAL] I'm just checking. She does have a dental policy. I don't have a medical policy on file for [PII]. Now, when you called that, did you call the [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me see here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, so I had that I was following up from a previous rep.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And she says that's 90 degree benefit. She called [PII].
[CUSTOMER][NEUTRAL] And per [PII].
[AGENT][POSITIVE] Mhm. That's right.
[CUSTOMER][NEUTRAL] M
[CUSTOMER][NEGATIVE] Her and this is a wellness only benefit plan and that is why the UB denied. She's faxing me a copy of the denial, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Now we had a claim for 1,503.
[CUSTOMER][NEUTRAL] That it looks like it was processed, let me see.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] But I can't tell the insurance company's name, so I guess.
[AGENT][NEUTRAL] It's gonna be the 90 degree benefits with that policy number you gave me, it's gonna be through them.
[CUSTOMER][NEUTRAL] It's uh-huh.
[CUSTOMER][NEUTRAL] OK, I'm, I'm looking on this um other charge because it looks like we got um.
[CUSTOMER][NEUTRAL] The professional fee um charge process so let's see if I can pull a policy number from that EOB that maybe we just have the wrong thing listed um.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] 1503 um.
[CUSTOMER][NEUTRAL] You said it begins with mm no that has the D too. It says 90 degree benefits though, hm.
[AGENT][NEUTRAL] Right, and there is when you call that number, if you choose option one, you get to speak to a representative with 90 degree benefits. If you choose option 2 for medical, the call comes to us, but we do not have her medical policy on file. What I can do, Desi, is I can transfer you back to 90 Degree benefits if you need to check on those claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that'll work.
[AGENT][NEUTRAL] All right, if you don't mind holding just one moment and again when you call that number to speak to them you're gonna choose option one.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] And it's been a pleasure to assist you does keep you on hold for the transfer, I hope you have a wonderful day.
[CUSTOMER][POSITIVE] I appreciate it.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Thank you for calling 90 Degree Benefits, the administrator for benefits in a card members.
[CUSTOMER][NEUTRAL] If you would like to participate in a quick survey after the call to rate your service with us, please press 1. Press 2 if no.