AccountId: 011433970860
ContactId: fa7b09fe-e6ce-4201-8f4c-8d8c590e6995
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1000359 ms
Total Talk Time (AGENT): 177652 ms
Total Talk Time (CUSTOMER): 145745 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/fa7b09fe-e6ce-4201-8f4c-8d8c590e6995_20250515T18:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh yes, hi, [PII]. My first name is [PII], my last name is [PII] calling you from the provider's office looking for claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Can I get a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh, yes, the callback number is [PII].
[AGENT][NEUTRAL] And can I get the policy number?
[CUSTOMER][NEUTRAL] Uh, the patient ID is, uh, just someone.
[CUSTOMER][NEUTRAL] The patient's ID 2331811.
[AGENT][NEUTRAL] OK, one moment while I pull that up for you.
[AGENT][NEUTRAL] Can I get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient's first name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] That of services uh September 28, 2023 and the total charge is $1,204 even.
[AGENT][NEUTRAL] And you said the date of service was [PII], what? I'm sorry.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just one moment.
[AGENT][NEUTRAL] You said the total charge is $1,0002?
[CUSTOMER][NEUTRAL] $1,204 even.
[AGENT][NEUTRAL] $204.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Do you know the provider?
[CUSTOMER][NEUTRAL] Uh, this is from the San Francis Medical Center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm not showing.
[AGENT][NEUTRAL] Anything for that date. Let me double check. You said [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm not showing anything for that provider, for that date of service.
[CUSTOMER][NEUTRAL] OK, uh, can I have the member's effective date?
[AGENT][NEUTRAL] Sure, give me one second and I can give you their eligibility.
[AGENT][NEUTRAL] It looks like this patient, this policy was effective on
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The policy lapsed [PII].
[CUSTOMER][NEUTRAL] OK, and the, uh, and there is no claim timely filing limit, right?
[AGENT][NEGATIVE] There is no timely filing.
[CUSTOMER][POSITIVE] Uh, thank you. Let's move to the next patient.
[AGENT][NEUTRAL] OK, give me one second. So you have a different claim for a different patient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, give me 1 2nd.
[AGENT][NEUTRAL] Let me add my notes real quick to this patient.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give me just a moment, I'm almost done.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, and what is the 2nd policy number?
[CUSTOMER][NEUTRAL] Um, the ID is 02302250.
[AGENT][NEUTRAL] And can I get you to verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII]. 1st name is [PII]. Last name is [PII]
[AGENT][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] And do you have the claim number or date of service for this claim?
[CUSTOMER][NEUTRAL] That of service [PII] total charge is $2,762.74.
[AGENT][NEUTRAL] Alright, one moment.
[AGENT][NEUTRAL] Give me just a moment. I'm looking for that charge.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] And what was the provider's name?
[CUSTOMER][NEUTRAL] Under the same provider Saint Francis Hospital.
[AGENT][NEUTRAL] I'm not showing one for that amount.
[AGENT][NEUTRAL] For that date of service?
[AGENT][NEUTRAL] I am seeing one for Saint Francis, but it is a different amount.
[AGENT][NEUTRAL] I'm not seeing one for $2,762.74.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] just so.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] 75.
[CUSTOMER][NEUTRAL] Uh, OK, uh, let's move to the next patient.
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] Let me put my notes in for this patient just real quick.
[AGENT][NEUTRAL] Give me just one moment.
[AGENT][NEUTRAL] Alright. And what is the 3rd?
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] 02131555.
[AGENT][NEUTRAL] All right, let me look it up.
[AGENT][NEUTRAL] Can I get the patient's name and date of birth on that one?
[CUSTOMER][NEUTRAL] The patient's uh first name is uh [PII] and the last name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you so much and what's the date of service?
[CUSTOMER][NEUTRAL] July
[CUSTOMER][NEUTRAL] [PII] total charges.
[CUSTOMER][NEUTRAL] $5340 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] Give me one moment. I'm looking that up real quick.
[AGENT][NEUTRAL] And is it the same provider?
[CUSTOMER][NEUTRAL] Uh, yes, Memorial Regional Medical Center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I am also not showing one for that provider or that amount for that date of service.
[CUSTOMER][NEUTRAL] Can I have the uh
[CUSTOMER][NEUTRAL] Can I have the members effective date?
[AGENT][NEUTRAL] OK, for this policy, it was effective on [PII].
[AGENT][NEUTRAL] And the policy lapsed on [PII].
[CUSTOMER][NEUTRAL] OK, is your send call reference number?
[AGENT][NEUTRAL] We don't have a call reference number, but you can use my name and my last initial in today's date. My name is [PII]. Last initial is [PII] as in [PII]. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Uh, no, that's all I need, thank you.
[AGENT][POSITIVE] Alright, thank you so much, [PII], for calling APL.
[CUSTOMER][POSITIVE] And have a very wonderful.
[AGENT][POSITIVE] OK. You have a great day, bye.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you, bye.