AccountId: 011433970860
ContactId: e34ded48-92e7-4bff-bdd2-6d22d602665b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 767409 ms
Total Talk Time (AGENT): 161810 ms
Total Talk Time (CUSTOMER): 175523 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=-1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/e34ded48-92e7-4bff-bdd2-6d22d602665b_20250303T14:54_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, sir. My name is [PII] calling from Mercy Hospital checking on the same status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, Ms. [PII], and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure. Um, patient policy number is 02069892.
[AGENT][POSITIVE] Thank you. Mm.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Member name is, uh, just a moment.
[CUSTOMER][NEUTRAL] Member name here is [PII]. Last name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Alright, um, thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Sure, data service here is uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] How much is the total charge?
[CUSTOMER][NEUTRAL] OK, so I
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Charge amount is $365 even.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, and let me see if I can find this claim for future, you can check claim status online through our website at [PII], and that's just optional. You can always call and.
[CUSTOMER][NEUTRAL] Yes, please help me with that.
[CUSTOMER][NEUTRAL] Uh, all right. Uh, could you please help me again with your website?
[AGENT][NEUTRAL] The what? I'm sorry?
[CUSTOMER][NEUTRAL] Could you please help me with your website? It's [PII].
[AGENT][NEUTRAL] The website. Yeah, the website is [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. Yes.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and let me pull this claim and see if it's yours. One moment.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK, so yes, this is it. All right. Looks like we processed the claim on [PII] and all payable benefits was applied towards the calendar year deductible.
[CUSTOMER][NEUTRAL] Um, just a moment. Uh, could you please help me first to receive data and process date of the screen?
[AGENT][NEUTRAL] OK, let me get the receipt date because that's not on the EOD so let me pull that information. One moment. It was processed [PII]. Let me see, it was received.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, it looks like it was received on the same day, so processed and received on the same day.
[CUSTOMER][NEUTRAL] Same day. All right. [PII], right? Uh-huh. All right. Uh, can you just uh send us the copy of UP through fax? I'll try to pull out if it's not, then you can send it just for backup.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what is the fax number?
[CUSTOMER][NEUTRAL] To fax
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] 306.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm repeating again. [PII]. Attention to my name, [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right. And uh uh how do you spell your name just to make sure I spell it correctly?
[CUSTOMER][NEUTRAL] Yes, sure. [PII].
[AGENT][NEUTRAL] OK, so what have, OK, um, if you don't mind holding for me, I can go ahead and send this out to you right now, OK?
[CUSTOMER][POSITIVE] Uh yeah, sure, sure, no issues.
[AGENT][NEUTRAL] One moment. OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for Miss [PII]. OK, I'll send that over to you. It should be there in a few minutes. Is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh sure. Please, could you please help me with the claim number?
[AGENT][NEUTRAL] Um, yes, the claim number is 353.
[AGENT][NEUTRAL] 1524.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] 24. All right. And uh what is your allowed amount?
[AGENT][NEUTRAL] I'm sorry, um, we don't have an allowed amount because we're just the secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh-huh, yes, yes, yes, I got it. So what is, uh, like how much you are paying, you're paying?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] We did not pay um the payable amount was applied towards the calendar year deductible.
[CUSTOMER][NEUTRAL] And deductible. How much? Is it 100 or?
[AGENT][NEUTRAL] Uh, it looks like $100 yes. Mhm.
[CUSTOMER][POSITIVE] $100 up to the deduct the, all right, thank you so much. Could you please help me with your name?
[AGENT][NEUTRAL] Mhm. My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] All right, sir. May I have your call reference number for this number?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] Uh yeah, sure, no issues. And uh so uh I have one more thing. Could you please help me with that? if you can.
[AGENT][NEUTRAL] Is it a different member?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, let me go ahead and finalize the note on this one so we can move forward to the next one. OK, one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] we
[AGENT][POSITIVE] OK, I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So, uh, here it is for different provider number is T as in Tango, I guess you have or not, I don't know. It's T as in Tango 50000738129.
[AGENT][NEUTRAL] That's not our policy number, Miss [PII].
[CUSTOMER][NEUTRAL] Uh, so maybe it's different. It's showing American now.
[CUSTOMER][POSITIVE] All right, sure, sure, this is public. All right, sure. Thank you so much for the information. Have a nice day.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] You as well, and thank you for calling APR. Have a good day, Ms. [PII]. Bye.
[CUSTOMER][NEUTRAL] Bye bye.