AccountId: 011433970860
ContactId: 1a64904c-69db-4c77-bc58-e03a57796be0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 632210 ms
Total Talk Time (AGENT): 181755 ms
Total Talk Time (CUSTOMER): 109562 ms
Interruptions: 2
Overall Sentiment: AGENT=-0.4, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/1a64904c-69db-4c77-bc58-e03a57796be0_20250326T19:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Pub Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, my name is [PII] calling from provider office looking for claim status.
[AGENT][NEUTRAL] OK, I can help you with that. Could I get the policy number you're calling on?
[CUSTOMER][NEUTRAL] Yes, policy number is 01813065 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient first name is [PII]. Last name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for that and you did say status today what is the uh data service you're calling on?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[CUSTOMER][NEUTRAL] And bill amount is $652 even.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] The total bill is 652.
[AGENT][NEUTRAL] What's the total bill again? 652. OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I do show the claim received on let me see.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One moment, sorry.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] OK, the claim was received on [PII]. Uh, it paid on [PII] $138.30 was applied, I'm sorry, paid to the provider, uh, that was a single check.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, I can see one procedure code uh J 9035 is denied. May I know the denial reason?
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Yeah yeah
[AGENT][NEUTRAL] J 9035. Let me check that one.
[CUSTOMER][NEUTRAL] Uh, what I.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's for uh one more time I'm sorry, uh, October. What is the date of service again on that one?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEGATIVE] OK. I showed that that particular charge was denied. Uh, the primary did not cover the charge.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh yes, uh, we had submitted primary pay EOB on [PII]. Did you receive that?
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For the [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] So let me see, it looks like it came in several times. Let me look and see, check the EOB.
[AGENT][NEUTRAL] Hold one moment for me please.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] Didn't cover.
[AGENT][NEGATIVE] Oh my gosh, this is so annoying.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] He said he did it on [PII].
[AGENT][NEUTRAL] So that would be.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 356-486-1
[AGENT][NEUTRAL] OK, that might be it. Let's see 21725349.
[AGENT][NEUTRAL] Mm, it ain't even on here. Let's make sure I know here.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] No why what?
[AGENT][NEUTRAL] 61.
[AGENT][NEGATIVE] Worse 59.
[AGENT][NEUTRAL] What's that way down there?
[AGENT][NEUTRAL] 353-0459.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] See procedure treatment has not been deemed OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 61.
[AGENT][NEUTRAL] So I want 91. What is 91?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, thank you for holding. I apologize for the wait. I have looked at all claims received. Uh, they were all denied um as a duplicate, uh, because the EOB that was received, it still shows that it was not covered by the primary.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We don't show any explanation of benefits.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][NEUTRAL] With patient responsibility applied to deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK. Thank you so much. Do you have fax number under which we can submit the primary UOB?
[AGENT][NEUTRAL] Sure, the fax number is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 94.
[AGENT][NEUTRAL] 23.
[CUSTOMER][POSITIVE] Thank you so much. And uh may I have the call reference number?
[AGENT][NEUTRAL] Yes, sir, to reference our call, you will use my name, [PII] and today's date.
[CUSTOMER][POSITIVE] Uh thank you so much, [PII]. Have a nice day. Bye for now.
[AGENT][POSITIVE] You have a wonderful day. Thank you for calling APL. Bye-bye.