AccountId: 011433970860
ContactId: e51e0f94-8009-490a-a677-c8185d29c12a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210059 ms
Total Talk Time (AGENT): 89127 ms
Total Talk Time (CUSTOMER): 81058 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/e51e0f94-8009-490a-a677-c8185d29c12a_20250515T14:21_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling with Franciscan Health. I'm just calling to follow up on a medical claim, please.
[AGENT][NEUTRAL] OK, I can verify claim status for you and you say your name is [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh, [PII], like Gone with the Wind. OK, and what's that policy number, please? Sorry.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, it's OK. Policy number is 02587043.
[AGENT][NEUTRAL] OK. Thank you, ma'am. Or I could say from True Blood. I don't know if you ever saw that show.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh uh, I've never seen either one of them, but I always hear that Gone with the Wind. That's usually what people say.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] There is a character named [PII], and she is one of the main characters in the show, which was really good. Um, do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] OK, and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you. And the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Uh, [PII] for $2,036.
[AGENT][POSITIVE] OK, thank you, ma'am. And give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] Franciscan Health.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, it looks like the claim is pending eligibility information from benefits and a card. Uh, once that information has been received, then the claim would be released.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so yeah, so I just called them because the EOB says that same thing and it tells me to contact benefits in the card and he he told me all he could verify was if the member had active coverage, which they do. So you're just waiting on something from them.
[AGENT][NEUTRAL] Yes ma'am. Once they show for that, uh, week of services, uh, that they were eligible, then they go back and repro or release the claim, but we're just waiting for benefits in the car to send us that.
[CUSTOMER][NEUTRAL] The process
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do you know what the time frame is for that typically?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mm, no. I'm assuming typically, usually.
[AGENT][NEGATIVE] I assume it comes to us kind of weekly, but we hadn't received anything. So, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I want to say maybe a week, but.
[CUSTOMER][NEUTRAL] Yeah, because when I called that benefit in a card, he had no, he was like, Oh, all I can tell you is that they're eligible. He said, Well, it says they're waiting on information from you, and he's like, you'll have to call them. So, OK, well, hopefully they will get that information to you soon and then the claim can get reprocessed.
[AGENT][NEUTRAL] Oh,
[AGENT][POSITIVE] Yes, ma'am. I'm sorry.
[CUSTOMER][NEUTRAL] That's OK. Is there a reference number for our call?
[AGENT][NEUTRAL] Uh, no, ma'am, but if you like, you may use my name at today's date.
[CUSTOMER][POSITIVE] OK, thank you so much for your help. You have a great day.
[AGENT][POSITIVE] Alright, you too, Ms. [PII]. Thank you for calling APL.
[CUSTOMER][NEUTRAL] Mhm bye bye.
[AGENT][NEUTRAL] Bye.