AccountId: 011433970860
ContactId: b111e410-8185-49e9-9826-58cb6332cd40
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 324000 ms
Total Talk Time (AGENT): 100962 ms
Total Talk Time (CUSTOMER): 160046 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/b111e410-8185-49e9-9826-58cb6332cd40_20250211T19:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, Ms. [PII]. My name is [PII] and I'm calling from Erlanger Medical Hospital, ma'am. And I'm calling to check the status of a claim.
[AGENT][NEUTRAL] All right, [PII]. Happy to check on a claim for you. What's the patient's policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. That is 018412777.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And if I could get the patient name and date of birth please?
[CUSTOMER][NEUTRAL] It's [PII]. Birth date is [PII].
[AGENT][NEUTRAL] Thank you. And then what is the date of service?
[CUSTOMER][NEUTRAL] It's [PII] for $11,571.09.
[AGENT][NEUTRAL] All right, thank you, [PII]. Let me take a look here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], do we by chance have an amount uh due after primary?
[CUSTOMER][NEUTRAL] Yes, but y'all paid $1,281.37. However, it left the balance of $806.17 and I needed to know what that was for.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I don't know if y'all didn't pay enough or is this part of the discount?
[AGENT][NEUTRAL] Uh, there were 2 claims for that date of service. Let me see here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I can tell you with primary pay.
[AGENT][NEUTRAL] OK, so we did receive it looks like one claim for the state of service charge amount was $2,087.54 and we paid $1,281.37 it looks.
[CUSTOMER][NEUTRAL] Yes, but the total charge was 11,000. You have that?
[AGENT][NEUTRAL] Mm mm, what I show charges 2,08754.
[CUSTOMER][NEGATIVE] Oh no, that's not enough. That's probably why y'all just pay that little bit amount.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let me see your EOP.
[CUSTOMER][NEUTRAL] And see what was on your ALP.
[CUSTOMER][NEUTRAL] Alright, y'all paid this on [PII], and no, this EOB is for $11,571.09.
[CUSTOMER][NEUTRAL] Um, I can give you the claim number.
[AGENT][NEUTRAL] Is it the one ending in 4653?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so it looks like the payment, the 1,28137 was the max benefit payable for that date of service, yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so it's the max benefit.
[CUSTOMER][NEUTRAL] OK, so what are we gonna do with the balance? Is that supposed to, is that supposed to be the discount?
[AGENT][NEUTRAL] So we're just the patients secondary. We're just cover, yeah.
[CUSTOMER][NEUTRAL] So let me
[CUSTOMER][NEUTRAL] Stack it, right.
[CUSTOMER][NEUTRAL] But um the primary paid.
[CUSTOMER][NEUTRAL] Um, $1,545.72 leaving a total of the patient's responsibility 2 $2,087.54. So that is why y'all paid that little bit amount cause y'all took it off of the patient's liability.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. All right. I, I think I understand now. So,
[CUSTOMER][NEUTRAL] Um, would I be able to get a copy of that faxed over to me so we can write off the balance?
[AGENT][NEUTRAL] Yeah, what's a good fax number?
[CUSTOMER][NEUTRAL] OK, that is [PII] and you could put on their attention [PII], and can you please put this um account number on it for me?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That is 87,420,120.
[AGENT][NEUTRAL] Alright, so just to confirm, the account number was 87,420,120?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And the fax number [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm sending that now.
[CUSTOMER][NEUTRAL] Now, Miss [PII], do y'all give out reference numbers?
[AGENT][NEUTRAL] Yes ma'am, so call references my name with my last initial and then today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, and what's your last name initial?
[AGENT][NEUTRAL] My last
[AGENT][NEUTRAL] It is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much, ma'am.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye bye.