AccountId: 011433970860
ContactId: bf159cd3-6350-4e75-afef-af04985eeb01
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 371339 ms
Total Talk Time (AGENT): 113014 ms
Total Talk Time (CUSTOMER): 112361 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/bf159cd3-6350-4e75-afef-af04985eeb01_20250326T19:56_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling from the provider's office to checking for claim status.
[AGENT][NEUTRAL] OK, sure. I can assist your claim status and may I have the spelling of your name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] Sure, the callback number is [PII].
[AGENT][NEUTRAL] And you're calling from which facility for my notation?
[CUSTOMER][NEUTRAL] Name of the specialty is?
[CUSTOMER][NEUTRAL] It's Sutter Rossville Medical Center.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Patient's member ID number is?
[CUSTOMER][NEUTRAL] 0
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 245-089-0.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the bill amount is $44,481.63.
[AGENT][NEUTRAL] OK. You said the date of service is January. Can you repeat the date?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that was $44,481.63.
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Are these the facility charges by any chance?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] I'm trying to locate that amount. I don't see that amount here. Um, let me check this claim, but I don't think this is it. One moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm. No, we have not received that claim. Now, this policy is uh terminated, um.
[AGENT][NEUTRAL] I can give you a termination date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The policy was affected um.
[CUSTOMER][NEUTRAL] Nothing in rejection too?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Is there anything in the rejection list?
[AGENT][NEUTRAL] There's no, no claim on file for this um for the date of service for that amount. There's no claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Go ahead with the effective date.
[AGENT][NEUTRAL] OK, that was [PII] and it terminated [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] The policy effective date was [PII] and it terminated [PII].
[CUSTOMER][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. OK. Sorry, your voice is breaking. Uh, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is there any other uh active policies with you other than this?
[AGENT][NEUTRAL] No, there's no other policies for this member.
[CUSTOMER][NEUTRAL] Do you show any other active insurance information for this patient?
[AGENT][NEUTRAL] No other with us, none that I can see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we have to coordinate with the patient for this one.
[CUSTOMER][NEUTRAL] T.
[CUSTOMER][NEUTRAL] OK. Uh,
[CUSTOMER][NEUTRAL] So no claims, nothing in uh for the date of services and the bill amount.
[AGENT][NEUTRAL] Correct, there's no claim on file.
[CUSTOMER][NEUTRAL] The patient was not active for the date of service. No other policies or no insurance information. OK, what would be the call reference number for this claim?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] Do you mind spelling your name for me?
[AGENT][NEUTRAL] That's [PII], last initial [PII].
[CUSTOMER][POSITIVE] Thank you. Have a great rest of your day. Take care. Bye bye.
[AGENT][POSITIVE] You as well thank you for calling APR.
[CUSTOMER][NEUTRAL] Yeah