AccountId: 011433970860
ContactId: c47d4f1a-39d9-413d-8364-9e39148f31fa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 360279 ms
Total Talk Time (AGENT): 117223 ms
Total Talk Time (CUSTOMER): 142204 ms
Interruptions: 1
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/c47d4f1a-39d9-413d-8364-9e39148f31fa_20250523T15:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], my name is [PII]. I'm calling on behalf of the Mercy Clinic East Community Provider Group, just needing to get status on a claim that was submitted, and it looks like [PII], but we've not received anything on it.
[AGENT][NEUTRAL] OK, let's take a look. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] I do. It is 02018413.
[AGENT][NEUTRAL] All right, let me pull that up, [PII]. Give me a sec.
[CUSTOMER][POSITIVE] Mhm, no problem.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] What is the patient's first and last name?
[CUSTOMER][NEUTRAL] It's on a Hay [PII].
[AGENT][NEUTRAL] I apologize, [PII]. Read that policy number to me one more time.
[CUSTOMER][NEUTRAL] 02018413
[AGENT][NEUTRAL] It doesn't bring up that name. I thought maybe I copied it down wrong.
[AGENT][NEUTRAL] Do we have their social or I can check by their name if I need to?
[CUSTOMER][NEUTRAL] Yeah, social is [PII].
[AGENT][POSITIVE] Alright, let me try that and see what I can.
[CUSTOMER][NEUTRAL] One second, when is it showing her?
[CUSTOMER][NEUTRAL] OK, it looks like the.
[CUSTOMER][NEUTRAL] Last name has changed recently because it shows [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Was the previous name.
[CUSTOMER][NEUTRAL] I'm gonna see when did they do they show in her name change.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hm.
[AGENT][NEGATIVE] Yeah, cause even her social is not bringing anything up for me. Nothing by.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEGATIVE] Nothing with even the first name [PII].
[CUSTOMER][NEUTRAL] OK, let me go. Let me check something here. Let me go into, uh, see if we have.
[CUSTOMER][NEUTRAL] See if we have a physical card on file in here for that might give us something different, uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, there's a.
[CUSTOMER][NEUTRAL] Yeah, APL
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. 00.
[CUSTOMER][NEUTRAL] The card shows it under her spouse, I'm guessing, which is a [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Family coverage and yeah the 02018413.
[AGENT][NEUTRAL] 020.
[CUSTOMER][NEUTRAL] But that oh my gosh that that copy yeah from effective [PII] on the card.
[AGENT][NEUTRAL] Alright, let me try [PII], last name, first name [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And that's on, yeah, for the, the copy of the actual card that we have yeah in our system that they provided.
[AGENT][NEUTRAL] All right. And the last name is [PII], is that how it's spelled?
[CUSTOMER][NEUTRAL] No, no, no, [PII]
[AGENT][NEUTRAL] And then, OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] What state did they reside in?
[CUSTOMER][NEUTRAL] Uh, let's see, they're in [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So weird that didn't come up that way because it shows [PII] mm.
[AGENT][NEUTRAL] Strange. OK, uh, for [PII], what's the uh date of service?
[CUSTOMER][NEUTRAL] OK, [PII] is the ID number that we have here with the exception to get an extra but yeah [PII].
[AGENT][NEUTRAL] Yeah, and that's.
[AGENT][NEUTRAL] Yeah, and that's what it came up as, yeah, [PII]. I don't know why that.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It's very strange.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] OK, date of service was [PII] for $125.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, we don't have any claims on file for [PII] that I see for [PII].
[CUSTOMER][NEUTRAL] OK, OK, yeah.
[CUSTOMER][NEUTRAL] Um, what would be the timely filing on that?
[AGENT][NEUTRAL] There's no timely filing, so it can, yeah, it can still be done.
[CUSTOMER][NEUTRAL] As far as
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and uh is there a fax that we can submit that to or does it just need to go back out through the mail?
[AGENT][NEUTRAL] No, I can give you the fax and then we have a payer ID also.
[CUSTOMER][NEUTRAL] OK, and your fax number?
[AGENT][NEUTRAL] Fax is gonna be [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and just attention claims?
[AGENT][NEUTRAL] Mhm, yeah.
[CUSTOMER][POSITIVE] OK perfect and I'm sorry, your name again?
[AGENT][NEUTRAL] That's OK. My name is [PII]. That's [PII] and if you need a call reference, it'll be my name with today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. That will work, sir. Thank you so much for all your help. You have a great holiday weekend.
[AGENT][POSITIVE] You too take care.
[CUSTOMER][NEUTRAL] All right, bye bye.