AccountId: 011433970860
ContactId: 30bf5a80-704f-424a-a23d-4be24d62a70b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 447609 ms
Total Talk Time (AGENT): 112081 ms
Total Talk Time (CUSTOMER): 138095 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/30bf5a80-704f-424a-a23d-4be24d62a70b_20250424T17:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office checking on claim status.
[AGENT][NEUTRAL] I'm sure [PII] I can assist you with claim status. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So call back number is [PII] I'm [PII].
[CUSTOMER][NEUTRAL] [PII] no extension number.
[AGENT][NEUTRAL] OK. Thank you. Um, now I need the policy number, please.
[CUSTOMER][NEUTRAL] So policy number 018977877.
[CUSTOMER][NEUTRAL] May I have your name?
[AGENT][NEUTRAL] My name is [PII]. It's spelled [PII] and my last initial is [PII].
[CUSTOMER][POSITIVE] Ay, thank you.
[AGENT][NEUTRAL] Mhm. No problem. Um, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Sure it's 01897877.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient named [PII]. Date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] [PII] and the bill amount is $145 even.
[AGENT][NEUTRAL] OK, yes, I show that we received this claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[CUSTOMER][NEUTRAL] Every
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number, the claim number is 357-4916.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I'm showing that this claim denied because under the patient's plan, office visits are not covered.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Office visits are not covered. OK, can we bill the patience for balance?
[AGENT][POSITIVE] Yes, sir, you can.
[CUSTOMER][NEUTRAL] OK. Are you process the claim as primary or secondary?
[AGENT][NEUTRAL] We're secondary.
[CUSTOMER][NEUTRAL] OK. Uh, could you please verify, uh, I'm sorry, could you please check, uh, who is the primary payer for this patient?
[CUSTOMER][NEUTRAL] Because we submit the claim as a primary.
[AGENT][NEUTRAL] We don't keep, we don't.
[AGENT][NEUTRAL] Right. We don't keep that information on file, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, office visits are not cover and it's patient liable patient.
[CUSTOMER][NEUTRAL] Liable. OK.
[CUSTOMER][NEUTRAL] And can I go to the next data service for the same patient?
[AGENT][NEUTRAL] Yes, what's the next date of service?
[CUSTOMER][NEUTRAL] Next year of service [PII] and the bill amount is $256 even.
[AGENT][NEUTRAL] OK, I show that we received this claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[CUSTOMER][NEUTRAL] money.
[AGENT][NEUTRAL] The claim number is 357-4917.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] And it denied for the same reason, office visits are not covered.
[CUSTOMER][NEUTRAL] OK, so the patient is liable, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. Could you please fax me a copy of EOB?
[AGENT][NEUTRAL] For both of them or just this one?
[CUSTOMER][NEUTRAL] Uh, both, both the guns and both the.
[CUSTOMER][NEUTRAL] You'll be sent to the same fax number.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Yeah, I really do.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][POSITIVE] OK, thank you. Yes, sir. Thanks for your patience. What's your fax number?
[CUSTOMER][NEUTRAL] Oh, use the fax number.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do I attention that to you?
[AGENT][NEUTRAL] The Shane
[CUSTOMER][NEUTRAL] Uh, attention, uh, no, no, you can use the patient's account number as attention.
[CUSTOMER][NEUTRAL] Uh, which is
[CUSTOMER][NEUTRAL] 253.
[CUSTOMER][NEUTRAL] 6804264
[AGENT][NEUTRAL] OK. And again, that fax number is [PII]?
[CUSTOMER][NEUTRAL] Yes, correct. And how long will it take to receive?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You should receive it in about 10 minutes.
[CUSTOMER][POSITIVE] OK, thank you very much. Can I have the reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. And again, my name is [PII] and it's spelled [PII] My last initial is [PII], and today's date.
[CUSTOMER][POSITIVE] OK, we thank you very much for the assistance and hope you have a wonderful day. Bye for now. Take care.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL mm bye.