AccountId: 011433970860
ContactId: 119e4acf-b468-417e-b0ca-cbda15ade11d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 402589 ms
Total Talk Time (AGENT): 74762 ms
Total Talk Time (CUSTOMER): 130053 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/119e4acf-b468-417e-b0ca-cbda15ade11d_20250210T22:26_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from the provider's office to check on a claim status.
[AGENT][POSITIVE] I'd be happy to assist with claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Sure, [PII]. There's no extension direct line.
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] The policy number will be?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It's 02544684.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] And what's
[CUSTOMER][NEUTRAL] I'm sorry, can you repeat it? I couldn't get that properly.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] What is the date of service claim that you're calling?
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, the date of birth is [PII].
[AGENT][NEUTRAL] Yes hello?
[CUSTOMER][NEUTRAL] Uh, can you hear me?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yeah, can you hear me now?
[AGENT][NEUTRAL] Yes, I can hear you now.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Uh, the date of service is [PII], with the total charge amount of $1,478 even.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello? Can you hear me? Hello?
[AGENT][NEUTRAL] What is your tax ID?
[CUSTOMER][NEUTRAL] The tax ID is [PII].
[AGENT][NEUTRAL] OK, I'm showing we made a payment of $50 on that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $50.
[CUSTOMER][NEUTRAL] OK. Um, uh, may I know about the remaining charges for the CPT 76805 and also about the remaining CPT code 76819 and 99204, please?
[AGENT][NEUTRAL] That would be patient responsibility and the $50 would be patient responsibility.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, can you hear me?
[CUSTOMER][NEUTRAL] Um, yeah, uh, I, I just, uh, just like the voice is going in and out, so I'm sorry for that and I couldn't get it properly. Can you repeat it again, please?
[AGENT][NEUTRAL] Um, anything over $50 that we paid is pay responsibility.
[CUSTOMER][NEUTRAL] Patient responsibility.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, OK. Got it. And could you please, uh, could you able to fax us the, uh, EPR EOB?
[AGENT][NEUTRAL] OK, uh, what's that fax number?
[CUSTOMER][NEUTRAL] Our fax number is [PII].
[AGENT][NEUTRAL] To whose attention?
[CUSTOMER][NEUTRAL] Um, you can use my name [PII], and the last name is [PII].
[AGENT][NEUTRAL] OK, you should receive that um within the uh.
[CUSTOMER][NEUTRAL] OK. And uh may I know, is there any denials in this claim for any CPT codes?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK on the 76805 so the other.
[AGENT][NEGATIVE] CPT codes were denied.
[AGENT][NEUTRAL] On
[AGENT][NEGATIVE] Because we had paid out the maximum, that's the only reason they denied.
[CUSTOMER][NEUTRAL] OK. May I know, uh, could you repeat the CPT code which was right? Is that 99204?
[CUSTOMER][NEUTRAL] 00, it's
[AGENT][NEUTRAL] Yeah, that one did not because we paid the $50 on the CPT code 76805, so the other two CPT codes did not for out.
[CUSTOMER][NEUTRAL] 76
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] So the maximum allowed will be the $50 alone, is that right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK, thank you so much and can I get a call reference number please?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date time of the call. Is there anything else I can assist with today?
[CUSTOMER][POSITIVE] No, that's it. That's all the information I needed and thank you so much for your kind assistance. Have a wonderful rest of the day and take care.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye bye.