AccountId: 011433970860
ContactId: b34bc38f-2be3-49c6-b57f-b308c5d5dc71
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 441920 ms
Total Talk Time (AGENT): 145482 ms
Total Talk Time (CUSTOMER): 105634 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/b34bc38f-2be3-49c6-b57f-b308c5d5dc71_20250130T19:39_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from Mercy Hospital checking on a claim status. Could you please spell out your name for me?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And [PII], you have one claim, [PII].
[CUSTOMER][NEUTRAL] I'm sorry, what is it?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And you said that you have, you're welcome, one claim to check status on, is that correct?
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am. I can help you. And what is your callback number, [PII]?
[CUSTOMER][NEUTRAL] It is [PII] I'm so sorry, it is [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] Um, yes, it is 01828903.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] And any information [PII] that I provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's, what's the last name again? I'm sorry?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the date of service and total bill amount for him please.
[CUSTOMER][NEUTRAL] [PII] with the total charges of $740 even.
[AGENT][NEUTRAL] I'm sorry, what is the total bill amount?
[CUSTOMER][NEUTRAL] $740 even.
[AGENT][NEUTRAL] $740 even, is that correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so this claim was received. It was received on [PII].
[AGENT][NEUTRAL] Processed on [PII].
[AGENT][NEUTRAL] The claim number is 352-271-5.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] This claim was denied. It states all benefits were excuse me, all payable benefits were applied to the policy deductible. $458.80 was applied to the deductible.
[CUSTOMER][NEUTRAL] So I
[CUSTOMER][NEUTRAL] Oh, so the balance will be patient responsibility, right?
[AGENT][NEUTRAL] We do not determine patient responsibility, that would be up to the provider.
[CUSTOMER][NEUTRAL] Yes, cause it was applied towards deductible, right?
[AGENT][NEUTRAL] To this policy's deductible, that is correct, but we do not determine patient responsibility. That would be up to the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and could you please send us a copy of EOB through fax?
[AGENT][NEUTRAL] Can you access the internet because you can print it directly from our portal, [PII], by going to [PII]?
[CUSTOMER][NEUTRAL] I don't know I can imagine.
[CUSTOMER][NEUTRAL] It would be more helpful if you would fax a copy of your to us.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Just a moment, please.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] I know no
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] The information is loading.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And will this need to be put to your attention?
[AGENT][NEUTRAL] Or is that not necessary? OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And do you, how do you spell [PII]?
[CUSTOMER][NEUTRAL] It is [PII] and my fax number is [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And again, that fax number is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK sir, so I have faxed that to you so provided that your line is able to receive it, you should be receiving that uh very shortly.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII]. And what would be the call reference number?
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][POSITIVE] Thank you so much. And your name is spelled as [PII], right?
[AGENT][POSITIVE] That is correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes, and for confirmation, the claim number is 352-2715.
[AGENT][POSITIVE] That is also correct.
[CUSTOMER][POSITIVE] Thank you so much. That is all I need. Have a great day ahead.
[AGENT][POSITIVE] OK. Well, thank you. You too, [PII], and thank you again for calling APL.
[CUSTOMER][POSITIVE] Have a great day ahead. Bye-bye. Take care.
[AGENT][POSITIVE] You too. Bye-bye. Bye, you too. Bye-bye.