AccountId: 011433970860
ContactId: cc3fa290-730d-498f-a2bf-f15de083ba1d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 506480 ms
Total Talk Time (AGENT): 123903 ms
Total Talk Time (CUSTOMER): 173911 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/cc3fa290-730d-498f-a2bf-f15de083ba1d_20250522T20:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], this is [PII] with Covenant Medical Group.
[AGENT][POSITIVE] Hi, how can I help you?
[CUSTOMER][NEUTRAL] I'm on your portal. I tried linking this up and nothing's coming, so I was hoping maybe you can tell me if it got stuck.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Where it decided to go.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, what's a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright and you said you're trying to get online?
[CUSTOMER][NEUTRAL] I've been online trying to find this claim she's got two claims, both in March.
[CUSTOMER][NEUTRAL] And neither one of them are on the portal. The portals saying no claims found.
[AGENT][NEUTRAL] OK, let me look. Um, what's the policy number?
[CUSTOMER][NEUTRAL] 02552172
[AGENT][NEUTRAL] OK, let me look that up.
[CUSTOMER][NEGATIVE] Didn't want you to think that I was wasting your time.
[AGENT][NEUTRAL] Uh, I can look it up for you. Uh, what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what was the date of service for one of them?
[CUSTOMER][NEUTRAL] Uh, [PII] for [PII].
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] OK, I'm showing that in here um would you like the claim number?
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] 35
[AGENT][NEUTRAL] 83815
[AGENT][NEGATIVE] And I'm showing that this claim was denied due to the policy providing no benefits for charges made by a doctor for inpatient visits.
[CUSTOMER][NEUTRAL] OK. If I put that number in, will it give me the EOB 0 ELB?
[AGENT][NEUTRAL] Um, it should give it to you if you like. I can fax it to you as well.
[CUSTOMER][NEUTRAL] Mm OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Oh it did. Oh good, OK.
[AGENT][NEUTRAL] Did it work?
[CUSTOMER][POSITIVE] Yeah, I love it when it works. It makes my life easier.
[CUSTOMER][NEUTRAL] The boss is making us go into the office with taxes.
[CUSTOMER][NEGATIVE] I'm like, you're just nuts. I only have one piece of paper I want.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, the other one I've got is [PII].
[AGENT][NEUTRAL] Alright, let me check.
[CUSTOMER][NEUTRAL] Is that one denied too?
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][POSITIVE] Cool.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Of this year.
[CUSTOMER][POSITIVE] You're a smart lady.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] What was the total bill amount?
[CUSTOMER][NEUTRAL] Uh, one, no, hold on, I can move my mousey.
[CUSTOMER][NEUTRAL] 394.
[AGENT][NEUTRAL] Alright, let me check.
[CUSTOMER][NEUTRAL] One cover procedure.
[CUSTOMER][POSITIVE] Well, East Blue Cross Blue Shield paid something on it, so she's good on that.
[AGENT][NEUTRAL] OK, and for that one?
[AGENT][NEGATIVE] It looks like it's the same denial reason.
[AGENT][NEUTRAL] And this policy does not provide benefits for diagnostic testing.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the claim number I have for this one?
[AGENT][NEUTRAL] It's 358 8.
[AGENT][NEUTRAL] 358.
[CUSTOMER][NEUTRAL] OK, let me get that one pulled.
[CUSTOMER][NEUTRAL] Mouse is doing funky stuff.
[CUSTOMER][NEUTRAL] It's what happens when you have two screens, you know, can't figure out where your mouse is.
[CUSTOMER][NEUTRAL] Oh, it's
[CUSTOMER][NEUTRAL] You get this weekend off?
[AGENT][POSITIVE] We do. I'm very happy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Cool. All right, I got that one too.
[AGENT][POSITIVE] You ready for the long weekend? All right, good.
[CUSTOMER][POSITIVE] Yeah, I asked her for tomorrow off and she done answered me.
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEGATIVE] I don't care. I'm not coming in tomorrow.
[AGENT][NEUTRAL] Just like.
[CUSTOMER][NEUTRAL] Even though it's like 5 ft from my bedroom, but I was.
[CUSTOMER][NEUTRAL] At it for this week. It's been one of those weeks where
[CUSTOMER][NEGATIVE] I made a lot of phone calls and a lot of portals aren't working and.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] They work and then they decide to crash and I'm like this is just.
[CUSTOMER][NEGATIVE] Drive me nuts.
[AGENT][POSITIVE] Well I will say we're working on getting a new portal that's supposed to be a lot easier to use, more user friendly, um, and it should be a lot easier, um, that should be rolling out soon, so be on the lookout for that as well and hopefully that will help too, um, since you're experiencing some problems with the online portal.
[CUSTOMER][NEUTRAL] Oh no, yours is yours is not as bad as Luisco's is because Luisco you can pull up and see that the person has coverage and then you click the button to get the claim and it says uh error message 404.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] And I've told them that and they're like, oh, can you?
[CUSTOMER][NEUTRAL] How do you replicate that? And I'm like, oh my gosh, y'all are the.
[CUSTOMER][NEUTRAL] Well that.
[AGENT][POSITIVE] Well, hopefully you get some good rest this weekend, OK? Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] No, you've been wonderful. I thank you so much for your time. Do we have a reference number or just use your beautiful name?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh, you'll use my name and last initial in today's date, so [PII] in today's date.
[CUSTOMER][POSITIVE] OK, cool.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, I appreciate your time. Thank you for doing that for me.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Anytime, [PII]. Uh, thank you for calling APL.
[CUSTOMER][POSITIVE] Thanks bye bye.
[AGENT][NEUTRAL] Alright bye.