AccountId: 011433970860
ContactId: da334b8a-04fc-4341-84d1-a18fc44afad6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 738119 ms
Total Talk Time (AGENT): 169055 ms
Total Talk Time (CUSTOMER): 189134 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/da334b8a-04fc-4341-84d1-a18fc44afad6_20250228T18:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I actually just talked to you on another claim, so I should have stayed on the line with you.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Is this [PII]?
[CUSTOMER][NEUTRAL] It is, yes.
[AGENT][NEUTRAL] Hi, [PII].
[CUSTOMER][POSITIVE] Hello, I was like, oh my gosh, I gotta call back. I'll probably get her and she'll be like.
[AGENT][NEUTRAL] Um, hello.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] No, that's OK.
[CUSTOMER][NEUTRAL] Oh goodness, yes, I just need to check the claim status for another claim please.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] OK, and what is the callback number again please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then the facility name?
[CUSTOMER][NEUTRAL] Uh, yes, this one is far hold on sorry, should I have that uh it is Mercy Clinic Lincoln Mercy Hospital Lincoln.
[AGENT][NEUTRAL] OK. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes mhm.
[CUSTOMER][NEUTRAL] [PII], excuse me, [PII].
[CUSTOMER][NEUTRAL] 02475697. I hope that's.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 02475697
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] 02475697 yes and that is on their card as well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] Yes, [PII], [PII], total charge of $157.
[AGENT][NEUTRAL] OK, and then what is the charge amount after the primary insurance paid your part?
[CUSTOMER][NEUTRAL] Oh, sure. $25.
[AGENT][NEUTRAL] $25. OK, [PII], I'm gonna put you on a quick hold while I look up that claim for us and I'll be right back. And also to let you know that fax from the previous call did make it through.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Absolutely mhm.
[CUSTOMER][POSITIVE] Yes, I was just gonna tell you, I, I was like, yeah, I was like, oh boy, that came through, yay! Thank you, I appreciate it.
[AGENT][NEUTRAL] I had my eye on it.
[AGENT][POSITIVE] Yeah. You're welcome. All right, it's gonna be a quick hold while I look this one up for you. I'll be right back.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Yes, ma'am, no problem. Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you for holding for me, [PII]. I've got um the claim number is.
[AGENT][NEUTRAL] 35432229
[AGENT][NEUTRAL] And the claim was denied because office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Sure, did you say 354-3229?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Uh, OK, yes, um, is there any way, what, what day did that process, [PII]?
[AGENT][NEUTRAL] Let me look real quick.
[AGENT][NEUTRAL] We received it on [PII] and processed it on [PII].
[CUSTOMER][NEUTRAL] OK, it's kind of the same scenarios. If I could get that, I don't know why we're not getting, I bet you what's happening is these are going to the physical location and we're just not getting these forwarded to our lockbox. So can I get this one faxed to me as well?
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Yes, and is it gonna be the same fax number you gave me before?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK I'm gonna put you on a quick hold and I'll get that right to you. I'll be right back.
[CUSTOMER][POSITIVE] Sure, sure, no problem.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK Miss [PII], I've got that fax on its way to you now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that sounds great. If can I ask for a look up on one more claim? Is that possible? or are you only allowed to take one per call or OK, OK, um.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] No, I can look another one up for you. What's the member's name?
[CUSTOMER][POSITIVE] Oh awesome.
[CUSTOMER][NEUTRAL] Yes, uh, this is for [PII]
[AGENT][NEUTRAL] OK, and [PII]'s date of birth and policy number?
[CUSTOMER][NEUTRAL] Uh huh, [PII] policy number of 02069892.
[AGENT][NEUTRAL] OK, let me pull in that policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK and then what is the data service?
[CUSTOMER][NEUTRAL] [PII] and $30 is what was left from the primary.
[AGENT][NEUTRAL] OK, and what was the original amount of the charge?
[CUSTOMER][NEUTRAL] $157 sorry that.
[AGENT][NEUTRAL] OK, that's OK. And is it for the same facility?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, yes, Mercy Hospital Lincoln, yes, with the same tax ID, yeah, mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's gonna be a brief hold. I'm gonna look this one up for you and I'll be right back. Thank you.
[CUSTOMER][POSITIVE] Sure, absolutely. No problem. Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me. I've got this one pulled up um the claim number is 355.
[CUSTOMER][NEUTRAL] Oh sure.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] 2113.
[AGENT][NEGATIVE] And it was denied for the same reason office visits are not covered by the member's policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Sure, sounds great. When did that process, please, [PII]?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Look.
[AGENT][NEUTRAL] We received it on [PII] and processed it on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Yeah and if we could get that fax that would be great.
[AGENT][POSITIVE] OK, brief hold again. I'm gonna get this ready for you. I'll be right back thank you.
[CUSTOMER][NEUTRAL] Yes, yes, ma'am.
[CUSTOMER][NEUTRAL] Mhm. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] I can tell you
[AGENT][NEUTRAL] Alright I've got that fax on his way to you now.
[CUSTOMER][POSITIVE] OK, OK, well I really appreciate [PII]verything and once again have a good weekend.
[AGENT][POSITIVE] You too, you too, [PII] thank you so much for calling APL. We'll talk to you later bye bye.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yes ma'am mhm bye bye.