AccountId: 011433970860
ContactId: f00beb6f-5871-4847-aad7-f33b7e264779
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 745289 ms
Total Talk Time (AGENT): 141121 ms
Total Talk Time (CUSTOMER): 147577 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/f00beb6f-5871-4847-aad7-f33b7e264779_20250423T14:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hello [PII]. My name is [PII]. That's [PII], and my surname initial is [PII]. I'm calling from the provider's office of Brookwood Medical Center to check on the claim that was sent back for reprocess last [PII]. I would like to know the status, please.
[AGENT][NEUTRAL] OK, I can help you with claim status [PII]. Can I please get your callback number, sir, just in case the call is disconnected.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yes, ma'am. It is [PII], no extension.
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] OK, uh, member's name is [PII]. I hope I pronounced that one correctly. [PII], uh, policy ID number is 02.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 539176. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you so much. Let me pull up um her policy real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] I think you did good doing that last name. I would pronounce it the same way.
[CUSTOMER][POSITIVE] OK, thank you for that.
[AGENT][NEUTRAL] OK, and then
[AGENT][NEUTRAL] You're welcome. And what is the data service?
[CUSTOMER][NEUTRAL] Uh, dated, uh, [PII] single date bill amount is $4,375 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And, um, what is the name of the facility you're calling from, sir?
[CUSTOMER][NEUTRAL] It's uh Brookwood Medical Center.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look up this claim and I'll be right back with you, [PII].
[CUSTOMER][POSITIVE] Yes ma'am, I'll wait for you then thank you.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you very much for holding for me, [PII]. I've got the claim number for you.
[CUSTOMER][NEUTRAL] Mm, yes, sir. Yes, sorry.
[AGENT][NEUTRAL] It
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] It's 35, OK, it's 355.
[AGENT][NEUTRAL] 865.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And the claim was denied because the benefit maximum for that date of service has been met. The benefit was exhausted.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so, having said that, please correct me if I'm wrong, uh, the entire claim we can build to the member then.
[AGENT][NEUTRAL] We don't give patient responsibility. We let the provider determine if they want to do that.
[AGENT][NEUTRAL] So it would be up to your billing department and their procedures as to what to do.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] OK, noted, thank you. So maximum benefit exhausted, am I right?
[AGENT][POSITIVE] You're correct.
[CUSTOMER][NEUTRAL] OK, thank you and I do apologize I missed some numbers for the claim number. What I have here is 355-8665. Did I got it correctly?
[AGENT][NEUTRAL] No, sir. It's 355-8635.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 0 35 got it thank you. And also, uh, sorry, can I request a copy of the denied EOB if there's any.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir. um, what is your fax number and I'll fax it to you.
[CUSTOMER][POSITIVE] Awesome. Uh, what is that? One moment. Let me pull up for you. OK, fax number is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold again while I get this fax ready for you, Don, and I'll be right back.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Uh thank you so much.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Come on, load.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] It's just taking its time.
[AGENT][NEUTRAL] Hm, come on, dude.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] What in the world like
[AGENT][NEUTRAL] There we go.
[AGENT][NEUTRAL] Like
[AGENT][NEUTRAL] Print this for me.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII], I wanted to let you know I haven't forgot about you. It's just taking a little bit to download.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mm, sure, no worries. So when and then uh when you're done, I just need the call reference number please.
[AGENT][NEUTRAL] So just, just.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, you can use my name [PII] and today's date.
[AGENT][NEUTRAL] I'm gonna put you on a quick hold again.
[CUSTOMER][NEUTRAL] Oh, so you're in good name and
[CUSTOMER][NEUTRAL] Oh sure, thank you. You are on hold.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Ah.
[AGENT][NEUTRAL] Come on.
[AGENT][POSITIVE] OK, finally
[AGENT][POSITIVE] Finally, finally.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the fax is [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, [PII]. I have that on its way to you now. It just took a minute for it to wake up.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh awesome.
[CUSTOMER][POSITIVE] Oh sure, I'll wait for you. Thank you. So yeah, I think I'm good now. Thank you so much, [PII] and have a good one. Bye for now.
[AGENT][POSITIVE] OK, you too, [PII], you have a great rest of your week and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you so much. Have a good one bye bye.
[AGENT][NEUTRAL] Bye-bye, sir.