AccountId: 011433970860
ContactId: 0c9b3393-3fa2-4e91-930f-4d383c65fa0f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 483630 ms
Total Talk Time (AGENT): 160311 ms
Total Talk Time (CUSTOMER): 154413 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/0c9b3393-3fa2-4e91-930f-4d383c65fa0f_20250613T19:26_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, uh, this is [PII] here, calling from office. I'm checking on a clients today.
[AGENT][NEUTRAL] OK, sure, I can assist you with claims. Can you spell your name?
[CUSTOMER][NEUTRAL] Uh, my name is [PII]. It's spelled like [PII]. I didn't catch your name earlier. Can I have your name again?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure. My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] Thanks for that.
[AGENT][NEUTRAL] You're welcome, Mr. [PII] and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] It's [PII]. It's a direct line, no extension.
[AGENT][NEUTRAL] OK. And may I have the name of the facility you're calling from for my notes?
[CUSTOMER][NEUTRAL] Uh, patient name is, sorry, the facility name is uh Community Medical Associates.
[AGENT][NEUTRAL] Community.
[AGENT][NEUTRAL] Medical Associate. OK. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. Uh, patient's policy number is gonna be 02449774.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII] and the date of birth is uh [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Uh, they are services it's like a date range. It's [PII], but the total amount of $1,303 even.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEGATIVE] I'm not gonna.
[AGENT][NEUTRAL] And for future you can check claim status online through our website at [PII] and that's just optional.
[AGENT][NEUTRAL] And um can you verify that um procedure code for me?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, can you verify the procedure code for me, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah, so the postal code is [PII] and [PII] and another [PII].
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Are they all in the same claim or they're separate claims?
[CUSTOMER][NEUTRAL] All in the same clime.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But I'm looking for the CPT code of 99223. It's billed for $688.
[AGENT][NEUTRAL] OK, let me pull this 11 moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like we last processed the claim on [PII].
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] Looks like it was not as a duplicate, um.
[CUSTOMER][NEUTRAL] you
[AGENT][NEUTRAL] The first time we were needing the primary EOB and we did not receive the primary ELB with the second submission. So we still need that primary EOB.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes, uh, we already submitted the primary UB along with the claim form on uh [PII]. After the [PII], uh, do you have uh any other claim has been received?
[AGENT][NEUTRAL] No, I don't see any other claims received for that date of service.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So the initial one got denied for primary UP right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Do you have the claim number of that?
[AGENT][NEUTRAL] Of the initial one?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, that is claim 3589743.
[CUSTOMER][POSITIVE] Thanks for that information and uh can have the received date of the initial claim.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 4.
[AGENT][NEUTRAL] OK, let me go ahead and correct that um claim number. Let me give you the correct claim number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, the correct claim number is 3589464.
[AGENT][NEUTRAL] And they received.
[CUSTOMER][NEUTRAL] It's 3589464, right?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and the received date for this one, you're welcome, is [PII].
[CUSTOMER][POSITIVE] Thanks for that.
[CUSTOMER][NEUTRAL] [PII]. Thanks for that information. Um, we can send the uh claim you'll be alone or uh we have to submit along with the claim form.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You can send it alone. We just need the primary EOB.
[CUSTOMER][NEUTRAL] OK. Thanks for that information and uh do you have any fax number for submitting the primary OB?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yes, the fax number is [PII].
[CUSTOMER][NEUTRAL] It's [PII], sorry, it's [PII], right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Thanks for that information. Just hold on a moment.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do you have any attention?
[AGENT][NEUTRAL] Claims department.
[CUSTOMER][NEUTRAL] Thanks for that information. Do you have any family time limit for that?
[AGENT][NEUTRAL] Hm.
[AGENT][NEGATIVE] We don't have timely filing limits.
[CUSTOMER][NEUTRAL] Thank you. And can I have the call reference number for this call?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name and today's date if you will.
[CUSTOMER][POSITIVE] Uh, thanks for that and thank you for assistance. Have a great day. Stay safe. Bye-bye.
[AGENT][POSITIVE] You as well, and thank you for calling APL. bye.