AccountId: 011433970860
ContactId: 06b65f72-0bcb-4f3c-ac4d-dd53f0573071
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 389100 ms
Total Talk Time (AGENT): 76752 ms
Total Talk Time (CUSTOMER): 142944 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/06b65f72-0bcb-4f3c-ac4d-dd53f0573071_20250523T19:16_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider office to check on claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] It's a direct line.
[CUSTOMER][NEUTRAL] I get that.
[AGENT][NEUTRAL] OK, thank you. And the policy number of the patient?
[CUSTOMER][NEUTRAL] 025.
[CUSTOMER][NEUTRAL] 873.
[CUSTOMER][NEUTRAL] 20
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] What's your name and date of birth?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Member name uh [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] And data service and bill charges.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, date of service [PII]. Total charge amount $469 even.
[AGENT][NEUTRAL] You say [PII]?
[CUSTOMER][POSITIVE] Yes, it's right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] For black is available.
[CUSTOMER][NEUTRAL] Give me the number.
[AGENT][NEUTRAL] Um, what was the provider's name?
[CUSTOMER][NEUTRAL] Yes, provider name is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, do you have any of the codes on the policy? I've got a couple of different dates or claims for this date of service.
[CUSTOMER][NEUTRAL] I mean the.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII]. It's [PII]. bill amount $469 even $469.
[AGENT][NEUTRAL] Do you have one of the CPT codes that's being billed?
[CUSTOMER][NEUTRAL] Yes, uh, we billed with the 3 CPD codes.
[AGENT][NEUTRAL] OK, and what, what were those?
[CUSTOMER][NEUTRAL] It's [PII] and 99214 and 36415.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, looks like we received this claim.
[AGENT][NEUTRAL] That was received on [PII].
[AGENT][NEUTRAL] Process 4-18-2025.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] I'm
[AGENT][NEUTRAL] Uh, it looks like the benefit maximum dollar amount was met for the date of service.
[CUSTOMER][NEUTRAL] OK, can you provide me the claim number?
[AGENT][NEUTRAL] 359-1167.
[CUSTOMER][NEUTRAL] 44
[CUSTOMER][NEUTRAL] You know
[CUSTOMER][NEUTRAL] OK. So, in this claim, um, is there any patient responsibility?
[AGENT][NEUTRAL] Um, it's a supplementary policy, so since it's supplemental and secondary or supplemental, it, we can't determine patient responsibility.
[CUSTOMER][NEUTRAL] No, uh, I didn't understand. Can you repeat again, please?
[AGENT][NEUTRAL] This is a supplemental policy, so we don't determine patient responsibility.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, uh, may I know the member annual, uh, annual amount of the benefit?
[AGENT][NEUTRAL] Uh yes, it is.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Uh, it pays 100.
[AGENT][NEUTRAL] For date of service for visit.
[CUSTOMER][NEUTRAL] OK, just give me a moment.
[CUSTOMER][POSITIVE] OK. Thank you so much. So, per day, the policy will pay.
[CUSTOMER][NEUTRAL] 100 per day, right?
[AGENT][POSITIVE] Yes, that's correct. Yes.
[CUSTOMER][NEUTRAL] For the patient?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] So for this, uh, can you send this copy of UB through fax?
[AGENT][NEUTRAL] What's your fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] 289
[CUSTOMER][NEUTRAL] 9254.
[AGENT][NEUTRAL] OK, I'll get that faxed over. It just takes a few minutes, 2 minutes.
[CUSTOMER][NEUTRAL] OK. Thank you. Can you provide me the call reference number?
[AGENT][NEUTRAL] The call reference number is my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you. Thank you for assisting me today. Have a good day. Bye-bye.
[AGENT][POSITIVE] Thank you for calling APL. You as well. Bye-bye.