AccountId: 011433970860
ContactId: 2d16d4f3-8c7b-47f9-a3e0-71aef8c76b2f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 406410 ms
Total Talk Time (AGENT): 69019 ms
Total Talk Time (CUSTOMER): 97913 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/2d16d4f3-8c7b-47f9-a3e0-71aef8c76b2f_20250619T16:41_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello. Hi, [PII]. This is [PII] calling from the provider's office.
[AGENT][NEUTRAL] OK, [PII], how can I help you?
[CUSTOMER][NEUTRAL] Yeah, I called regarding to the claim status.
[AGENT][NEUTRAL] Yeah, I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] [PII] with an extension of [PII].
[AGENT][NEUTRAL] OK, and what was the policy number for the patient?
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Yeah, 01807645.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient name is [PII].
[CUSTOMER][NEUTRAL] And date of birth, it's [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and bill charges?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the total charge $3,321.
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Sure, please take your time.
[AGENT][NEUTRAL] OK, looks like we received this claim on 11-27-24.
[AGENT][NEUTRAL] Process 122 2024.
[CUSTOMER][NEUTRAL] Just a moment. I'll just make a note of it.
[CUSTOMER][NEUTRAL] Syndrome?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] You receive the payment?
[AGENT][NEUTRAL] I received the claim 1127-24.
[CUSTOMER][NEUTRAL] Process loan
[AGENT][NEUTRAL] 122 2024.
[CUSTOMER][NEUTRAL] For 2.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's like
[AGENT][NEUTRAL] Outpatient benefit for the calendar year was met, dollar amount?
[CUSTOMER][NEUTRAL] So you mean deductible last night?
[AGENT][NEUTRAL] No, the outpatient benefit payable for the calendar year was met.
[CUSTOMER][NEUTRAL] What is that amount?
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] That's 500.
[CUSTOMER][NEUTRAL] $500.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEGATIVE] You did not, I didn't receive any EOB for this.
[AGENT][NEUTRAL] You need an EOB, is that what you said?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. What's the fax number?
[CUSTOMER][NEUTRAL] Yeah, it's 636.
[AGENT][NEUTRAL] You know
[CUSTOMER][NEUTRAL] 248
[CUSTOMER][NEUTRAL] 9151.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, that's her.
[CUSTOMER][NEUTRAL] So [PII], I have a question regarding this, uh, so this the claim was not processed, right? They, it was processed to the outpatient benefits. So is there any chance, so there is no choice of processing, there is no payment on this.
[AGENT][NEUTRAL] Correct, it was denied. It was the outpatient benefit max was met.
[CUSTOMER][NEUTRAL] So, OK. Yes. Can you hold on a minute, just a moment.
[CUSTOMER][POSITIVE] Thanks for holding on the line, [PII]. Thank you so much. So did you fax that uh EOB for us?
[AGENT][NEUTRAL] I'm faxing it right now. It should just take a few minutes.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Let me know after you've done the fax.
[AGENT][NEUTRAL] OK, I've sent that fax, and do you need to check on another claim, or?
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Yeah, no, there are no other claims. Thank you so much for the um information, [PII]. I'll wait for the fax and, uh, in the mean, can I have the call reference number for this?
[AGENT][NEUTRAL] Uh, call reference is my name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][POSITIVE] Great, sir. Thank you so much for your time. Have a good day.
[AGENT][POSITIVE] Thank you for calling APL. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.