AccountId: 011433970860
ContactId: f32bb275-3f6c-4ccc-a9cd-78595cd0d126
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 483119 ms
Total Talk Time (AGENT): 143347 ms
Total Talk Time (CUSTOMER): 85629 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/f32bb275-3f6c-4ccc-a9cd-78595cd0d126_20250221T21:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello [PII], this is [PII]. I'm calling from Colonial Family Practice. I have two claims for a patient I need to check status on.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with your claim status. um, can I please get your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] It's [PII]. My extension is [PII].
[AGENT][NEUTRAL] Thank you and then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It's [PII] [PII] policy is 01746108.
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[AGENT][NEUTRAL] OK, and then what's the date of service?
[CUSTOMER][NEUTRAL] Her first day of service is [PII].
[AGENT][NEUTRAL] And the charge amount please?
[CUSTOMER][NEUTRAL] $307.08.
[AGENT][NEUTRAL] OK, and then what is the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] After primary is $40.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, Ms. [PII], while I pull up this claim and I will be right back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you for holding for me, Ms. [PII]. So I have the claim, um, the claim number is 3539812.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim has two remarks on it. Uh, the first one is all or part of the payable benefits applied to the policy deductible of $100.
[AGENT][NEUTRAL] And then the second remark is insured, primary insurance provided full benefits, there are no benefits payable.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And when was that processed?
[AGENT][NEUTRAL] Let me look for you.
[AGENT][NEUTRAL] We received it on [PII] and processed it on [PII].
[CUSTOMER][NEUTRAL] Alright, are these EOBs out on the portal that I can print because I'm not showing that we've received them and I can print them and send them to my payment posters.
[AGENT][NEUTRAL] Uh yes ma'am, it should be on the portal for you, um, claims and.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] EOBs for providers.
[CUSTOMER][NEUTRAL] OK, she's got one more.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Data service and that data service is 1024 24.
[AGENT][NEUTRAL] What's
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] 321 72.
[AGENT][NEUTRAL] And then the charges after primary.
[CUSTOMER][NEUTRAL] Uh, $40.
[AGENT][NEUTRAL] OK, I'm gonna put you on brief. Is it for the same facility, the Colonial Family?
[AGENT][NEUTRAL] Clinic, OK, I'm gonna put you on a brief hold again while I look this up. I'll be right back.
[CUSTOMER][POSITIVE] Yes, that's correct mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you for holding for me, Ms. [PII]. I've got this claim number is 353-9796.
[AGENT][NEUTRAL] And it's also got a couple remarks on it. The first one is office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the second one is insured primary insurance provided full benefits. There are no benefits payable.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] And then also there was a remark this policy does not provide a benefit for services in which no charges were rendered.
[AGENT][NEUTRAL] We occurred.
[CUSTOMER][NEUTRAL] OK, yeah, she's got some qualities. OK, can I get a call reference number, [PII]?
[AGENT][NEUTRAL] Yes, you can use my name. It's [PII] and today's date.
[CUSTOMER][POSITIVE] Yeah sorry about that. All right, thank you so much.
[AGENT][NEUTRAL] That's OK.
[AGENT][POSITIVE] All right. You take care, Ms. [PII], and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][NEUTRAL] Bye-bye, ma'am.