AccountId: 011433970860
ContactId: fc9cbf66-5969-41c3-903b-fe90491cb275
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 453459 ms
Total Talk Time (AGENT): 98339 ms
Total Talk Time (CUSTOMER): 96223 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/fc9cbf66-5969-41c3-903b-fe90491cb275_20250527T15:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from a Sy Health Medical Group, and I'm calling in reference to a claim, well, to 2 claims for this one patient.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And you have the patient policy number?
[CUSTOMER][NEUTRAL] It is 02597992.
[AGENT][NEUTRAL] And what was the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEUTRAL] And what was the date of service and bill charges?
[CUSTOMER][NEUTRAL] Um, the first one is [PII] for $766.
[AGENT][NEUTRAL] OK, you said 766, is that right?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Sorry, my system's running just a bit slow.
[CUSTOMER][POSITIVE] Oh, it's OK. Thank you.
[AGENT][NEUTRAL] Well, I have a date of er I have that date of service, but um, do you know what CPT code it was billed with?
[CUSTOMER][NEUTRAL] Um, this one is 99232 and 99223.
[AGENT][NEUTRAL] let me
[AGENT][NEUTRAL] OK, it looks like, let's see.
[AGENT][NEUTRAL] Uh, it was your C4 11 and process 418.
[AGENT][NEUTRAL] And looks like.
[AGENT][NEUTRAL] Um, there's no coverage for charges for inpatient physician.
[AGENT][NEUTRAL] This is like a limited supplemental hospital indemnity plan, has very limited coverage.
[CUSTOMER][NEUTRAL] OK. Thank you um for that. Will this be patient responsibility or?
[AGENT][NEUTRAL] Um, it's a supplemental policy, so we can't instruct on patient responsibility since it's supplemental.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And then um do you mind checking on one other claim for me?
[AGENT][NEUTRAL] Yeah, absolutely. What was that data service?
[CUSTOMER][NEUTRAL] Uh, date of service [PII].
[AGENT][NEUTRAL] And bill charges?
[CUSTOMER][NEUTRAL] $936.
[AGENT][NEUTRAL] That was the same patient, right?
[CUSTOMER][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] OK, that one was received on 48, process 428, and
[AGENT][NEUTRAL] Is this for inpatient as well?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Uh yes, that's correct.
[AGENT][NEUTRAL] It looks like the policy termed on 330-2025.
[AGENT][NEUTRAL] Or 3:31. I'm sorry.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All righty. Um, and then, where, um,
[CUSTOMER][NEUTRAL] Where can I locate the EOB for that claim that you just provided me the details of?
[AGENT][NEUTRAL] Um, it's on [PII].
[AGENT][NEUTRAL] Um, have you all created an account?
[AGENT][NEUTRAL] Before
[CUSTOMER][NEUTRAL] Um, I'm not sure if there's been one created yet, um.
[AGENT][NEUTRAL] You'll just need your tax ID and then you'll need the patient, your patient account number that's on the um HIFA 1500.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, all righty then. Uh, we'll take you for that, um, there.
[CUSTOMER][NEUTRAL] And then will there be a call reference number?
[AGENT][NEUTRAL] Uh, call reference number is just my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][POSITIVE] Thank you for calling APL. I hope you, hope you have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] OK.