AccountId: 011433970860
ContactId: c8c2bd4b-0398-4555-9541-10a374e6c360
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1011530 ms
Total Talk Time (AGENT): 250396 ms
Total Talk Time (CUSTOMER): 183393 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/c8c2bd4b-0398-4555-9541-10a374e6c360_20250115T21:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check on the claim status.
[CUSTOMER][NEUTRAL] And may I know your last name, [PII]?
[AGENT][NEUTRAL] OK, Ms. [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] I can help you with the claim status. I can help you with the claim status, Miss [PII]. What is your callback number please?
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] It's [PII], and you told me your last name which is [PII], right?
[AGENT][NEUTRAL] OK. And then what is the patient's name?
[CUSTOMER][NEUTRAL] Uh, patient name is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] And then what is [PII]'s policy number, please?
[CUSTOMER][NEUTRAL] Policy number is 020522207.
[AGENT][NEUTRAL] OK, let me get that policy pulled up for us real quick.
[AGENT][NEUTRAL] And the policy is 020522207. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and then what is the date of service?
[CUSTOMER][NEUTRAL] It's for
[CUSTOMER][NEUTRAL] [PII], we build the amount of $175 even.
[AGENT][NEUTRAL] Of $100 even?
[CUSTOMER][NEUTRAL] $175 even.
[AGENT][NEUTRAL] 173 even.
[CUSTOMER][NEUTRAL] 75
[AGENT][NEUTRAL] 75.
[CUSTOMER][NEUTRAL] 175.
[AGENT][NEUTRAL] Even, OK.
[AGENT][NEUTRAL] And then what is the uh charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Primary care, uh.
[CUSTOMER][NEUTRAL] Give me a second.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] It's uh $30.
[AGENT][NEUTRAL] $30. OK, and then what is the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Mla Regional Medical Center.
[AGENT][NEUTRAL] OK, Ms. [PII], I'm gonna put you on a brief hold while I look up that claim for you and I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, you said the date of service was [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm gonna put you on hold again. I'm still searching.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi Ms. [PII], searching for data service for [PII]. I do not find a claim on file for miles owed them, policy number 205,220.
[AGENT][NEUTRAL] 07. I'm sorry.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK. So can move for the next set of service.
[AGENT][NEUTRAL] Ma'am?
[CUSTOMER][NEUTRAL] Can move for the next date of service.
[AGENT][NEUTRAL] Effective date?
[AGENT][NEUTRAL] OK, let me put my note in and we'll move on to the next one when I'm finished. I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, Ms. [PII], is the next um data of service for the same um insured?
[CUSTOMER][NEUTRAL] Yeah, same. Before that, may I know the payer ID and the eligibility for this member?
[AGENT][NEUTRAL] Yes, the eligibility is, the effective date is [PII].
[AGENT][NEUTRAL] And the policy terminated on [PII].
[AGENT][NEUTRAL] And the payer ID is 60801.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the next date of service is for.
[AGENT][NEUTRAL] OK, what is the next day of service?
[CUSTOMER][NEUTRAL] Give me a second.
[CUSTOMER][NEUTRAL] Uh, [PII], sorry, [PII] we build the amount of $175 even.
[AGENT][NEUTRAL] And what was that bill amount again please one more time?
[CUSTOMER][NEUTRAL] $175 even.
[AGENT][NEUTRAL] 124 even. OK, and then what was the charge amount after?
[CUSTOMER][NEUTRAL] 175,1, OK. The bill amount is 175 and uh after
[CUSTOMER][NEUTRAL] And actually the full amount.
[AGENT][NEUTRAL] You said it was $175?
[CUSTOMER][NEUTRAL] Mm yeah.
[AGENT][NEUTRAL] And then what is the charge amount after the primary paid their part?
[CUSTOMER][NEUTRAL] It's full amount 175.
[AGENT][NEUTRAL] OK, I'm gonna put you on hold again. I'm gonna look that up. I'll be right back with you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, looking for data service of [PII] and the amount of $175 I do not find a claim on file.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. You can move for the next set of service for the same patient.
[AGENT][NEUTRAL] OK, what is the next date of service?
[CUSTOMER][NEUTRAL] Uh, [PII] with build amount of $932 even.
[AGENT][NEUTRAL] OK. I'll put you on hold. I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi Miss [PII] looking on that data service that there isn't a claim on file for that date of service either.
[CUSTOMER][NEUTRAL] OK, so tell me the last date of service for this claim. It is [PII] with bill amount of 175.
[AGENT][NEUTRAL] Of how much? 173?
[CUSTOMER][NEUTRAL] 175.
[AGENT][NEUTRAL] 175. OK, let me see.
[AGENT][NEUTRAL] I've got that date pulled up already, so it should be easy.
[CUSTOMER][POSITIVE] My goodness.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, Ms. [PII], it's the same thing. There is not.
[AGENT][NEUTRAL] A charge amount for 175 for the data service of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so I mean the call reference for this call, this claim.
[AGENT][NEUTRAL] Yes, ma'am. You can use my name. It's [PII] and today's date.
[CUSTOMER][NEUTRAL] OK. So can you move for the next member?
[AGENT][NEUTRAL] OK, let me add my note and I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] All right, Ms. [PII], what is the next?
[AGENT][NEUTRAL] Insured's name?
[CUSTOMER][NEUTRAL] Uh, give me a second.
[CUSTOMER][POSITIVE] I get no better.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] I'm sorry, I didn't understand.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] The next member ID I have here is.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] 02440625.
[AGENT][NEUTRAL] OK, and what's the member's name?
[CUSTOMER][NEUTRAL] Member ID is uh sorry member name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and then what is the date of service?
[CUSTOMER][POSITIVE] God bless you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Date of services for [PII] with build amount of $384 even.
[AGENT][NEUTRAL] OK, let me pull in that policy real quick.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and what's the name of the facility?
[CUSTOMER][NEUTRAL] It's Mala Regional Medical Center.
[AGENT][NEUTRAL] OK, I'm gonna put you on hold again. I'll be right back.
[CUSTOMER][NEUTRAL] OK. You are on hold.
[AGENT][NEUTRAL] Hi Ms. [PII], this is [PII] back with you. I'm looking for data service 53 of 2024 for $384. I do not find the claim on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so, can you move for the next date of service for the same patient's going to the last.
[AGENT][NEUTRAL] OK, what is the next date of service?
[CUSTOMER][NEUTRAL] [PII] it bill amount of 261.
[AGENT][NEUTRAL] OK, I'm gonna put you on hold I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, we have the same thing going on with this one. I don't find a claim on file for data service 424 $24 in the amount of $261.
[CUSTOMER][NEUTRAL] OK. So may I know the effective date of this number?
[AGENT][NEUTRAL] Yes, this member's effective date is.
[AGENT][NEUTRAL] [PII] and the policy terminated on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The festive date.
[AGENT][NEUTRAL] Is there anything else I can help you with, Ms. [PII]?
[CUSTOMER][POSITIVE] Yeah, no. Thank you so much for your assistance. Have a good day.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You have a great day too. Thanks for calling APL. Bye bye.
[CUSTOMER][NEUTRAL] And you, before that you told me the pay ID is 6801, right?
[AGENT][POSITIVE] Yes, 60801. That's correct.
[CUSTOMER][NEUTRAL] 60
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] And thank you for assistance. Have a good day.
[AGENT][POSITIVE] You're welcome, Ms. [PII]. Bye-bye. Thanks for calling APL.