AccountId: 011433970860
ContactId: 039779ca-6146-4086-9d35-1ad9b0ff910e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 349190 ms
Total Talk Time (AGENT): 94650 ms
Total Talk Time (CUSTOMER): 141382 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/039779ca-6146-4086-9d35-1ad9b0ff910e_20250325T15:49_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from A provider office. Could you help me with the claim status, please?
[AGENT][NEUTRAL] OK, I'm sorry. What was your name?
[CUSTOMER][NEUTRAL] It's [PII] and the last initial is [PII].
[AGENT][NEUTRAL] OK, I can bare barely hear you. It's [PII]
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] And do you have a callback number I can get?
[CUSTOMER][NEUTRAL] Yes, I do have uh [PII] with the extension of [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, I do have the policy number is 02473074 M as in Mike L as in Lima H.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][NEUTRAL] Sure, before that, can you please spell out your name for my documentation?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And last of your name.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] And what was the patient's name?
[CUSTOMER][NEUTRAL] Sure. The patient's first name is [PII] and the last name is [PII] And date of birth is
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And you are needing claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can look that up for you. What was the date of service?
[CUSTOMER][NEUTRAL] The data service is [PII] with the total bill amount of $1,214 even.
[AGENT][NEUTRAL] And it was 10.
[AGENT][NEUTRAL] 29, 10.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes, it's 10 to 9 of 2024.
[AGENT][NEUTRAL] OK, hold on one moment, please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what is the procedure code?
[CUSTOMER][NEUTRAL] Mhm, allow me one moment please.
[CUSTOMER][NEUTRAL] The procedure code is there are two line items for the slim. One is 74,160. Another one is Q9967.
[AGENT][NEUTRAL] OK. 74,160.
[AGENT][NEUTRAL] 29967.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] that is 9967. Yes, that's right.
[AGENT][NEUTRAL] Q 9967. OK.
[CUSTOMER][NEUTRAL] Oh, I'm so sorry. There are only one line item for this, sorry, I'm so sorry. The line item is 74,160. That's it.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's the name of the facility? Are you with the facility or the doctor's office?
[CUSTOMER][NEUTRAL] First elite imaging.
[AGENT][NEUTRAL] OK, and it was 12:14 was the total charge?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEGATIVE] OK, we did get that claim and it, it was denied. That was paid to the insured.
[CUSTOMER][NEUTRAL] Mhm. So when was it received?
[AGENT][NEUTRAL] It was received.
[AGENT][NEUTRAL] 1125 24.
[CUSTOMER][NEUTRAL] Mhm. When was it processed?
[AGENT][NEUTRAL] It was processed 11/27, 24.
[CUSTOMER][NEUTRAL] Mhm hm. So could you please provide the claim number?
[AGENT][NEUTRAL] 3535535.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me verify it's 353553-5, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mhm. So may I know the exact reason?
[AGENT][NEUTRAL] It was paid to our insured.
[CUSTOMER][NEUTRAL] Our insured, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What do you mean by that?
[AGENT][NEUTRAL] We paid the patient.
[CUSTOMER][NEUTRAL] So patient is responsible for this, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So you do not pay any payment, right?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] 0 payment OK.
[CUSTOMER][NEUTRAL] Can you please provide your to reference number?
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] Thank you so much. Allow me one moment please.