AccountId: 011433970860
ContactId: 08977e54-80c2-4dbe-b8b3-f3da864d8afb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283170 ms
Total Talk Time (AGENT): 117550 ms
Total Talk Time (CUSTOMER): 112130 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/08977e54-80c2-4dbe-b8b3-f3da864d8afb_20250221T21:44_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hello, [PII] calling from provider's office regarding our claims.
[AGENT][POSITIVE] All right, [PII], it would be my pleasure to assist you. What is the callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And [PII], what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Uh, policy number is 02568950 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Thank you, [PII]. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Pa's first name is going to be?
[CUSTOMER][NEUTRAL] Uh [PII] and the last name is [PII].
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] Yeah, date of service is [PII].
[AGENT][NEUTRAL] And what is the patient's date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with that claim status. What is the facility name?
[CUSTOMER][NEUTRAL] Facility name is Gastro Health LLC.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Uh, we received that claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] like.
[AGENT][NEUTRAL] It was processed and denied on [PII], denied as office visits are not covered, and that is for the guidelines of the patient's plan.
[CUSTOMER][NEUTRAL] Like your offices are not gone and this one member's plan. May I know what is, could you please help me the member's plan name?
[AGENT][NEUTRAL] That's
[AGENT][NEUTRAL] It's a secondary gap policy meddling gap.
[CUSTOMER][NEUTRAL] You got it. Uh, like, uh, can you send me the copy of your with the fax.
[AGENT][NEUTRAL] ELBs are obtainable on our provider portal at [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] and it is a simple self-registration.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can you please help me the show, got it. Could you please help me the claim number?
[AGENT][NEUTRAL] Claim number is
[CUSTOMER][NEUTRAL] On the call reference please.
[AGENT][NEUTRAL] Yes, sir. Claim number is 3554531.
[CUSTOMER][NEUTRAL] 3554531. Got it. Uh, OK, you are not sending, uh, it is not possible to send the copy of your, right?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Excuse me, hold just one moment.
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] I can send that EOB is quicker to get it off the portal, and I can help you with that if you'd like.
[CUSTOMER][NEUTRAL] Yeah, sure, please, ma'am.
[AGENT][NEUTRAL] If you will go to
[CUSTOMER][NEUTRAL] And the.
[AGENT][NEUTRAL] If you will go to [PII].
[AGENT][POSITIVE] I can help you get registered and you'll have that EOB immediately.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, just give me a second. Uh, like, uh, upon checking with this claim number, I'm unable to like pull the claims.
[AGENT][NEUTRAL] Do you have an online account?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, I'm checking on it.
[AGENT][NEUTRAL] Do you have it under that tax number [PII]?
[CUSTOMER][NEUTRAL] posted 17 posted.
[AGENT][NEUTRAL] 400983
[CUSTOMER][NEUTRAL] Yeah, like, just give a second, just give me a second, uh, like I have been, uh, submitted with the wrong the member's name, uh, upon checking, like, yeah, I got the your pieces. Yeah, thank you. Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] My pleasure. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Let me check whether I have any claims for this one. Just give me one moment please.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So, uh, upon checking, I don't see any claims. Could you please help me the call reference and, and spell your name with the last name and so please. That is all the information I need for today.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] First initial last name, [PII], and reference number would be my name and today's date.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Sure. Uh, thank you, [PII]. That's all the information and thank you for assistance.
[AGENT][POSITIVE] It's been my pleasure to assist you today, [PII]. Thank you for calling APL and have a wonderful weekend.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] You too. Bye for now.
[AGENT][NEUTRAL] Bye bye.