AccountId: 011433970860
ContactId: c209fbcc-6f01-4bff-a6f4-312cd502854b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 452320 ms
Total Talk Time (AGENT): 164427 ms
Total Talk Time (CUSTOMER): 147435 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/c209fbcc-6f01-4bff-a6f4-312cd502854b_20250221T16:58_UTC.wav
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[AGENT][POSITIVE] Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from MSKCC to check on a claim status.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you. You said your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you. And what is the callback number, please?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's 1896483.
[AGENT][NEUTRAL] Thank you, [PII]. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] The patient name is [PII] and the date of birth, [PII].
[AGENT][POSITIVE] Alright thank you and it would be my pleasure to assist you with that claim status. What is the data service?
[CUSTOMER][NEUTRAL] Data service is [PII]. Bill amount $550 even.
[AGENT][NEUTRAL] Thank you and what is the facility name please ma'am?
[CUSTOMER][NEGATIVE] Sorry, come again.
[AGENT][NEUTRAL] The facility name.
[CUSTOMER][NEUTRAL] Yeah, the facility name is MSKCC Radiology Group.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] All right, thank you, [PII], and it would be my pleasure to assist you with that claim status. [PII], we did receive that claims.
[AGENT][NEUTRAL] On [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] And it was denied as the services were rendered after the policy turned.
[CUSTOMER][NEUTRAL] Uh, when the, uh, claim was denied, denied date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] You said [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, sorry. [PII] for the.
[AGENT][POSITIVE] No problem.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, may I know when the member was, uh, for to date?
[AGENT][NEUTRAL] The effective date is [PII] I'm sorry, [PII] and turned on [PII]. I apologize, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] When the call was last updated?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Is there any active other insurances pay for this number?
[AGENT][NEUTRAL] Not for this member with our company, no, ma'am.
[CUSTOMER][NEUTRAL] OK, uh, for, uh,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, no other insurances there, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] May I get the claim number?
[AGENT][NEUTRAL] The claim number is 351.
[AGENT][NEUTRAL] 2309.
[CUSTOMER][POSITIVE] Thank you so much. I have for this uh patient hire 2 more claims. Shall I provide that?
[AGENT][NEUTRAL] Yes, what's that next claim, uh, data service?
[CUSTOMER][NEUTRAL] One moment. Let me put the claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's just loading. The next data services.
[CUSTOMER][NEUTRAL] Uh, [PII] and the charge amount $630 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Same provider.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Provider, uh, I think it's different. I
[CUSTOMER][NEUTRAL] The provider name is [PII] Li Zhang.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the facility name for that claim?
[CUSTOMER][NEUTRAL] Uh, it's MSK CC. One moment.
[CUSTOMER][NEUTRAL] Let me check.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's MSKCC Ray Group.
[AGENT][NEUTRAL] Is that nuclear medicine Medical Group?
[CUSTOMER][POSITIVE] Yes, yes. Right.
[AGENT][NEUTRAL] OK. All right, thank you. Uh that claim we received on
[AGENT][NEUTRAL] Getting that received date for you, bear with me.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] That claim was received on [PII].
[AGENT][NEUTRAL] And processed on [PII].
[AGENT][NEUTRAL] And that claim was denied for the same reason.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I get the claim number?
[AGENT][NEUTRAL] That claim number is 351.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 2207.
[CUSTOMER][POSITIVE] OK, thank you so much. Uh, shall we move on to the next data service?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The next date of service is uh [PII] and the charge amount $650 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] The facility name is MSK CCady Group.
[AGENT][NEUTRAL] The same as the nucleared group.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEGATIVE] And send that claim we received on [PII] and processed on [PII] and denied for the same reason.
[CUSTOMER][NEUTRAL] Can I get the claim number?
[AGENT][NEUTRAL] Claim number is 351.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 2223.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you so much. Could you please spell out your name and
[AGENT][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] And the first initial of my last name is [PII].
[CUSTOMER][POSITIVE] OK. Thank you, [PII].
[CUSTOMER][NEUTRAL] Thank you. May I get the reference number?
[AGENT][NEUTRAL] The reference number is my name and today's date, and I spell my uh spelled my name. I apologize. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Oh, that's all from my end. Thank you for your assistance.
[AGENT][POSITIVE] And thank you for calling APL sender. Now it was a pleasure to assist you and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Bye-bye.