AccountId: 011433970860
ContactId: f747e625-5db2-4fbf-bd24-46a0875e19be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219270 ms
Total Talk Time (AGENT): 85325 ms
Total Talk Time (CUSTOMER): 87279 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/f747e625-5db2-4fbf-bd24-46a0875e19be_20250204T16:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. My last initial is [PII], and I'm calling from Mass General Hospital. And I'm trying to check eligibility on this.
[CUSTOMER][NEUTRAL] Patient
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] And to see if you have the claim on file.
[AGENT][NEUTRAL] Yes, Ms. [PII], I can um check eligibility and check claim for you. Can I please get your callback number, ma'am, just in case our call is disconnected.
[CUSTOMER][NEUTRAL] It's a direct line, [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the patient's name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's policy number please?
[CUSTOMER][NEUTRAL] 01986594 and Mary L Lucy 8.
[AGENT][NEUTRAL] OK, thank you and then for the claim, what is the data service?
[CUSTOMER][NEUTRAL] [PII] with a total charge of
[CUSTOMER][NEUTRAL] $12,136.26.
[AGENT][NEUTRAL] Thank you. And then what is the charge after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Ah, so you're a secondary insurance.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, let me take a peek here.
[CUSTOMER][NEUTRAL] That's not I think we build you prime. Let me just peek.
[CUSTOMER][POSITIVE] We build you prime.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Let me look and see if the claim came through.
[AGENT][NEUTRAL] It did come through, um, it did come through the claim number is 343-8419.
[CUSTOMER][POSITIVE] That'd be great.
[AGENT][NEUTRAL] Let me check real quick to see what the.
[CUSTOMER][NEUTRAL] Oh I I lost you in there. I'm sorry.
[AGENT][NEUTRAL] It's 343-841-9 is the claim number.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEGATIVE] And it was denied.
[AGENT][NEUTRAL] Because we need the explanation of benefits from the primary insurance.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the patient's policy is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] Through present. OK.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] What is your timely filing?
[AGENT][NEUTRAL] We don't have one as long as the insured was covered on the date of service you can file at any time.
[CUSTOMER][POSITIVE] Beautiful. Thank you very, very much, [PII]. Do you have a call ref number?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name and today's date.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Why.
[CUSTOMER][POSITIVE] OK. [PII], you've been extremely helpful. Thank you very, very much. You have a wonderful day.
[AGENT][POSITIVE] You too, Miss [PII] you have a blessed one and thanks for calling APL.
[CUSTOMER][NEUTRAL] Bye now.
[AGENT][NEUTRAL] Bye-bye.