AccountId: 011433970860
ContactId: b6fcdd73-8f42-4f99-8d36-8fe6b97d4708
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 455619 ms
Total Talk Time (AGENT): 114499 ms
Total Talk Time (CUSTOMER): 96026 ms
Interruptions: 1
Overall Sentiment: AGENT=-0.2, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/b6fcdd73-8f42-4f99-8d36-8fe6b97d4708_20250107T19:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII] calling from Mercy Hospital, checking on a claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status. um, can you please give me your call back number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][NEUTRAL] Thank you and what's the patient's name?
[CUSTOMER][NEUTRAL] My name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and what's the insured's policy number?
[CUSTOMER][NEUTRAL] It is 018287667.
[AGENT][NEUTRAL] OK, let me pull in that policy for us real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what is the service?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] OK, and the charge amount?
[CUSTOMER][NEUTRAL] $120 even.
[AGENT][NEUTRAL] And what is the charges after primary paid their part?
[CUSTOMER][NEUTRAL] $29.29.
[AGENT][NEUTRAL] Thank you. And then you said you're calling from Mercy Hospital?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up that claim for you, Miss [PII]. I'll be right back.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, Miss [PII]. So I did find the claim. The claim number is 33909.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sorry, 3, your voice is in and out.
[AGENT][NEUTRAL] 75
[AGENT][NEUTRAL] 339.
[AGENT][NEUTRAL] 0975.
[AGENT][NEUTRAL] Claim was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the claim was denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Just a moment. The claim was denied on [PII].
[AGENT][NEUTRAL] Yes, because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Actually, we already submitted the primary insurance COP.
[CUSTOMER][NEUTRAL] Uh, on.
[CUSTOMER][NEUTRAL] 3 27 2024.
[CUSTOMER][NEUTRAL] To the address PO box?
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] OK, I do see that we did get something on.
[AGENT][NEUTRAL] To let's see.
[AGENT][NEUTRAL] For Mercy Hospital but the charge amount is different.
[CUSTOMER][NEUTRAL] Mm, we already submitted the primary insurance on [PII].
[CUSTOMER][NEUTRAL] Charge on just $120.
[AGENT][NEUTRAL] Oh wait, the date you changed the, you said [PII] because before you said different. OK, let me look on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] No, ma'am. We have not received anything for [PII].
[CUSTOMER][NEUTRAL] OK, so claim process done. OK, can you please let me know the address to submit those.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] You'll send it to [PII].
[AGENT][NEUTRAL] And that's [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK, just [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And what is the timely filing?
[AGENT][NEUTRAL] There isn't one.
[CUSTOMER][NEUTRAL] No TFL. OK, can you please spell your name?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] Call the number.
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][POSITIVE] Thanks for providing information. Have a nice day bye bye.