AccountId: 011433970860
ContactId: 0b6cab82-b2e9-44f2-aad9-3d8c6e63206c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298579 ms
Total Talk Time (AGENT): 65110 ms
Total Talk Time (CUSTOMER): 89993 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/0b6cab82-b2e9-44f2-aad9-3d8c6e63206c_20250618T14:24_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office. I would like to check the claim status.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Mhm, sure, my callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And the policy number for the patient?
[CUSTOMER][NEUTRAL] Sure. The policy number which is 02425331.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] The date of service and bill charges?
[CUSTOMER][NEUTRAL] Yes, the date of service is um [PII] with the bill amount of uh
[CUSTOMER][NEUTRAL] $2460 even.
[AGENT][NEUTRAL] Oh, you said 20,460, is that right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, looks like we received the claim 332025 process 35-2025.
[AGENT][NEUTRAL] A maximum benefit payable occurrence has been met.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I know the maximum calendar, your maximum amount?
[AGENT][NEUTRAL] It's 500.
[CUSTOMER][NEUTRAL] And when it was met?
[AGENT][NEUTRAL] Yeah, it's been on [PII].
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] OK. But our dos is uh prior [PII], right?
[AGENT][NEUTRAL] That was the, the date it was met, not the date of service. The date of service was [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. So, may I know the claim number?
[AGENT][NEUTRAL] 3571622.
[CUSTOMER][NEUTRAL] OK. So, actually, we filed two different claims for same day of service. The one which you provided, which we already received the EOB and for this, uh the ranging provider is different.
[AGENT][NEUTRAL] OK, is there, you're saying there's another claim for the exact same dollar amount?
[CUSTOMER][NEUTRAL] That are
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, that looks like that claim was received 33-2025 process 312.
[AGENT][NEGATIVE] And denied for the same reason.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can I have the claim number?
[AGENT][NEUTRAL] 357-4682.
[CUSTOMER][NEUTRAL] And could you please uh provide me the copy of EOB through my fax?
[AGENT][NEUTRAL] For both or which one?
[CUSTOMER][NEUTRAL] The 2nd 1.
[AGENT][NEUTRAL] OK. What's your facts?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, I'll get that sent over. It just takes a few minutes. Is there anything else I can help with today?
[CUSTOMER][NEUTRAL] Yes. May I know the reference number for the call?
[AGENT][NEUTRAL] My name is [PII] and today's date.
[CUSTOMER][POSITIVE] Mhm thank you so much, [PII], for providing this information. Have a great day bye bye.
[AGENT][POSITIVE] Thank you for calling APLU as well. Bye bye.