AccountId: 011433970860
ContactId: d06646cf-30c5-4266-94c4-d8d7b28a3189
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 389809 ms
Total Talk Time (AGENT): 150207 ms
Total Talk Time (CUSTOMER): 128887 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/d06646cf-30c5-4266-94c4-d8d7b28a3189_20250610T17:09_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from Holy Cross Hospital to check on the claim status.
[AGENT][NEUTRAL] OK, I can check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] Uh, my name is [PII], spelled as [PII].
[AGENT][NEUTRAL] Got you. Uh, so, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII] and extension will be [PII].
[AGENT][NEUTRAL] May. OK, thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yeah, I have the policy number as 124.
[CUSTOMER][NEUTRAL] 1931, M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, got it and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, my first name is [PII].
[AGENT][NEUTRAL] Do you have that date of birth?
[CUSTOMER][NEUTRAL] Yeah, and the [PII].
[AGENT][NEUTRAL] Thank you for verifying that. Uh, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII]. OK, one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK and then uh what was billed amount please?
[CUSTOMER][NEUTRAL] Uh, it will be $57,376.24.
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Uh, so, do you have the, uh, tax ID for this provider?
[CUSTOMER][NEUTRAL] Yeah. Let me provide you the tax ID.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, tax ID number will be [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, uh, was that amount that you gave me was that before or after major medical paid?
[CUSTOMER][NEUTRAL] Uh, you need the after amount?
[AGENT][NEUTRAL] Please.
[CUSTOMER][NEUTRAL] Yeah, it's a balance, it will be like uh $350 even $350.
[AGENT][NEUTRAL] 350, OK.
[AGENT][NEUTRAL] I'm not showing that we've received a claim for that amount um I have several claims from the provider for that date of service but none for that amount.
[CUSTOMER][NEUTRAL] Yeah, you don't have for the both amount, right, and the bill amount as well the balance amount?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Uh, can you please uh provide me the claim mailing address?
[AGENT][NEUTRAL] Yes, that is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 50, like, uh actually, [PII], we have submitted this claim initially [PII] Public Life, [PII]. That's the incorrect mailing address, right?
[AGENT][NEUTRAL] I see. No.
[AGENT][NEUTRAL] Yeah, that's
[AGENT][NEUTRAL] That's correct, yes, the one that I just gave you in [PII], that is our correct claims mailing address.
[CUSTOMER][NEUTRAL] OK, [PII]. Uh, can you please provide me the payer ID?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Uh, payer ID is 60801.
[CUSTOMER][NEUTRAL] One. can you please provide me patient effective and termination date?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, yes, and I will say that the policy number that you gave me was one that was not active during the state of service, so I do have that policy number whenever you're ready.
[CUSTOMER][POSITIVE] Yeah, I'm ready for that.
[AGENT][NEUTRAL] OK, that is 0251.
[AGENT][NEUTRAL] 43.
[AGENT][NEUTRAL] 38
[CUSTOMER][NEUTRAL] Uh, can you please provide the, the effective information date for this uh new member ID?
[AGENT][NEUTRAL] Yes, so effective date was [PII].
[AGENT][NEUTRAL] And that termination date was [PII].
[CUSTOMER][NEUTRAL] [PII]. And uh this member ID is active. Uh, can you please provide me the initial uh one like initial member ID effective date?
[AGENT][NEUTRAL] The one that uh you had given me first?
[CUSTOMER][NEUTRAL] Yeah, right.
[AGENT][NEUTRAL] Yeah, that one's effective date was uh [PII].
[AGENT][NEUTRAL] And that termination date was [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, what was the effective to [PII], right?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Effective date for that first one that was just the [PII].
[CUSTOMER][NEUTRAL] OK, got it. Uh thanks for that. Uh, what's the timely filling limit?
[AGENT][NEUTRAL] There is a timely filing limit.
[CUSTOMER][NEUTRAL] Uh, no timely selling limit?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can you provide me the caller reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Um so my name is spelled [PII], last initial [PII], and was there anything else I could help you with?
[CUSTOMER][POSITIVE] Uh, no, and thank you very much for your valuable information. Have a great day.
[AGENT][POSITIVE] Of course, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.