AccountId: 011433970860
ContactId: eef2d9b3-5305-48ad-b730-7032bbc42067
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 552599 ms
Total Talk Time (AGENT): 166788 ms
Total Talk Time (CUSTOMER): 148768 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/2025/06/05/eef2d9b3-5305-48ad-b730-7032bbc42067_20250605T13:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. How are you doing today?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][POSITIVE] I'm doing good. My name is [PII]. I'm calling from Hampton Regional and I'm calling to check claim status.
[AGENT][POSITIVE] All right, [PII], I'm happy to check on a claim for you today. Do we have the patient's policy number?
[CUSTOMER][NEUTRAL] I do. It is 801-023-206.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, let's see here.
[AGENT][NEUTRAL] Bear with me just one moment please. Let me take a look here.
[AGENT][NEUTRAL] What is the insured's first and last name?
[CUSTOMER][NEUTRAL] It is for [PII].
[AGENT][NEUTRAL] Hm, OK, that wasn't a policy number. It didn't bring up anything under [PII]. Can you, do you, can you spell the last name? I can take a look by the name if you'd like.
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] And first name is [PII]
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Alright, let's take a look for that.
[AGENT][NEUTRAL] Uh, do you know what state does the patient reside in?
[CUSTOMER][NEUTRAL] Um, yes, ma'am. They are in.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] What is her date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what was the data service?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] The dating service is gonna be 713-2024 through [PII].
[AGENT][NEUTRAL] OK. And then do we have a bill amount?
[CUSTOMER][NEUTRAL] Yes, the bill amount is $8,393.32.
[AGENT][NEUTRAL] Do you by chance have a different amount after primary paid?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well that was the amount that we billed to primary and then forward it to secondary so I'm not sure what amount would come over um I can tell you that the difference between the bill amount and primary payment is, give me one second to do a little math.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Oh, Primary didn't pay anything. They apply everything to the deductible and copay, so they, there should not have been a difference because they didn't pay.
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let me just double check this one right here. Give me just a second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] OK, yeah, I don't see that we ever got a claim.
[AGENT][NEUTRAL] Oh let's see, you said it was 83 94 32 correct?
[CUSTOMER][NEUTRAL] 83 9332.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You did get it then, all right.
[CUSTOMER][NEUTRAL] The because I have, yeah, it's basically we sent over an outpatient claim and a professional claim and the professional claim was 470.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so it looks like
[AGENT][NEUTRAL] We did get the claim. It looks like it was processed and it looks like the 250 that was payable was applied towards their deductible on the secondary.
[CUSTOMER][NEUTRAL] OK, can I have that process date and claim number which uh is that the facility claim or the proty claim?
[AGENT][NEUTRAL] This is a facility claim it looks like.
[CUSTOMER][NEUTRAL] OK, can you give me that process date and claim number?
[AGENT][NEUTRAL] Absolutely. So it was processed on [PII].
[AGENT][NEUTRAL] And then that claim number is gonna be 353-6153.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you said it applied how much?
[AGENT][NEUTRAL] It looks like the payable amount was $250 and that was applied towards their deductible.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And did you get the, did you all get the profi claim for 470?
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] You said it was 4:30 on the other one, is that correct?
[CUSTOMER][NEUTRAL] 470.
[AGENT][NEUTRAL] Oh, I'm sorry, 470.
[CUSTOMER][NEUTRAL] You're fine. You're fine.
[AGENT][NEUTRAL] Let's see. OK, so it looks like we did get that one.
[AGENT][NEUTRAL] That one was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it looks like portion of the payable benefit for the charge was applied to the policy's emergency room deductible.
[CUSTOMER][NEUTRAL] OK, can I have that claim number as well?
[AGENT][NEUTRAL] Absolutely. It's gonna be 351.
[AGENT][NEUTRAL] 238 9.
[CUSTOMER][NEUTRAL] OK, and what was that allowed amount that was applied to the deductible?
[AGENT][NEUTRAL] It's showing the charge amount we show is for the 1 is 116 11, so that was the amount.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] OK, thank you so much. Is there a call reference number? I'll get this bill to the patient.
[AGENT][NEUTRAL] Absolutely. Call reference is gonna be my name with today's date. My name again is [PII], that's [PII] Last initial to my name is [PII], and then today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Thank you so much, Ms. [PII].
[AGENT][POSITIVE] You're welcome, [PII]. Have a good day.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][NEUTRAL] Bye bye.