AccountId: 011433970860
ContactId: ba660a09-cded-4371-bf8e-4d7f579c2182
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 358480 ms
Total Talk Time (AGENT): 119621 ms
Total Talk Time (CUSTOMER): 103198 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/ba660a09-cded-4371-bf8e-4d7f579c2182_20250516T15:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] speaking. I'm calling regarding some claims. I'd like to know the claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. May I please get your callback number?
[AGENT][NEUTRAL] Just in case the call is dropped.
[CUSTOMER][NEUTRAL] Sure. Uh [PII].
[CUSTOMER][NEUTRAL] Mhm. [PII].
[AGENT][NEUTRAL] And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] And patient, full name is [PII] Date of birth is [PII].
[CUSTOMER][NEUTRAL] Policy number is
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 334379.
[AGENT][NEUTRAL] OK, let me look up this policy real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I've got him pulled up. Can you please give me the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Mhm. Date of service is [PII]. Bill amount is $292.
[AGENT][NEUTRAL] OK, and you said you were the [PII].
[CUSTOMER][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] OK and then what are the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Let me check.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] An amount of $2013.53. 213.53.
[AGENT][NEUTRAL] OK, and what is the balance?
[CUSTOMER][NEUTRAL] And the remaining amount is $15.
[AGENT][NEUTRAL] OK, and then may I also have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Mhm. From secure Mercy Health.
[AGENT][NEUTRAL] OK, I'm gonna put you on a hold, Miss [PII], while I look up this claim right back with you.
[CUSTOMER][NEUTRAL] I'm sorry, the code is. You are on hold.
[AGENT][POSITIVE] Thanks, ma'am.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Thank you for holding for me, Ms. [PII]. So I have the claim information ready for you.
[CUSTOMER][NEUTRAL] We
[AGENT][NEUTRAL] The claim number is 357-435-4.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That it, got it. Mhm.
[AGENT][NEUTRAL] And the claim has been denied because office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] I'm sorry, could you please repeat the name because I'm sorry.
[AGENT][NEUTRAL] Uh, yes, ma'am.
[AGENT][NEUTRAL] The claim has been been denied because office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] I understood.
[CUSTOMER][NEUTRAL] Yeah. Maybe your system appears on a specific denial code.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me check that out for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The denial code is D as in dog 2 H as in Henry 0001.
[CUSTOMER][POSITIVE] Perfect. Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK, and that's gonna be all. I have a question and there isn't a specific portal where I can check multiple claims.
[AGENT][NEUTRAL] Yes, ma'am. Let me give that to you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Are you ready? It's secured, [PII]
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you're gonna go in there as a provider.
[CUSTOMER][POSITIVE] Perfect. Thank you.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEUTRAL] OK. Could you please provide me a reference number?
[CUSTOMER][POSITIVE] Mhm. Thank you.
[AGENT][NEUTRAL] Yes, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Alright. Thank you so much. That was really helpful, OK? Have a nice day and take care. Bye-bye.
[AGENT][POSITIVE] Well, you're very welcome, Ms. [PII]. You have a wonderful weekend and thank you for calling APL. Bye-bye, ma'am.
[CUSTOMER][POSITIVE] Mhm. Thank you. You too.