AccountId: 011433970860
ContactId: 3252467b-90d2-43c2-810e-1ad07a5c5aeb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 320739 ms
Total Talk Time (AGENT): 94718 ms
Total Talk Time (CUSTOMER): 150048 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=2.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/3252467b-90d2-43c2-810e-1ad07a5c5aeb_20250523T21:24_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Very good afternoon. This is [PII] calling from provider's office just checking on payment status and the last name is [PII].
[AGENT][NEUTRAL] OK, and I'm sorry, your name is again, spell it for me.
[CUSTOMER][NEUTRAL] [PII], and the last name is [PII].
[AGENT][NEUTRAL] I'm sorry, spell your name again for me. I can't hear your phone cut out.
[CUSTOMER][POSITIVE] Oh, sorry for that. I apologize. The name would be [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the policy number, please?
[CUSTOMER][NEUTRAL] My pleasure. And the policy number would be 01841206 M as in Mike L as in Lima 7.
[AGENT][NEUTRAL] Thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Uh yes, callback number would be [PII] direct line only.
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][POSITIVE] No problem for that take your time.
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Hello, do you need to pay?
[CUSTOMER][NEUTRAL] Oh for sure, Patience's last name would be [PII], and the first name as [PII]
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][POSITIVE] Thank you so much for that. Date of service would be [PII].
[AGENT][NEUTRAL] OK, and the amount of the charge?
[CUSTOMER][NEUTRAL] At.
[CUSTOMER][NEUTRAL] $348 even.
[AGENT][NEUTRAL] And what was the balance after primary Insurance processed the claim?
[CUSTOMER][NEUTRAL] Oh, just a moment checking for that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much for holding and the balance was co-pay amount for the patient that would be.
[CUSTOMER][NEUTRAL] $55 even.
[AGENT][NEUTRAL] Verify the uh the name of the provider's office.
[CUSTOMER][NEUTRAL] Oh for sure, just a moment. I was providing that information.
[CUSTOMER][POSITIVE] And thank you so much for that holding and the provider's name would be Gastro Health LLC.
[AGENT][NEUTRAL] OK, I'm showing that claim process says office visits are not covered per the policy.
[CUSTOMER][NEUTRAL] You stated that you received the uh claim and denial has non-co charges as per patient plan. Is that right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you so much for that. And can you please provide me the claim number for this?
[CUSTOMER][POSITIVE] No problem for that.
[AGENT][NEUTRAL] Sure, one moment.
[AGENT][NEUTRAL] Uh, claim number 354-9300.
[CUSTOMER][POSITIVE] Thank you so much for that. And the amount would be the same as copay, $55 even, is that right?
[AGENT][NEUTRAL] Well, we don't, I don't know what, you have to contact the patient. We don't give patient responsibility. The claim was not paid, it was denied, so you need to contact the patient.
[CUSTOMER][NEUTRAL] huh.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] In regards to any patient responsibility.
[CUSTOMER][POSITIVE] Thank you so much for that. Can you please
[CUSTOMER][NEUTRAL] Can you please provide uh fax that EOB to our fax number?
[AGENT][NEUTRAL] Sure. Uh, also we do have an online service center where providers can check claim status as well as print out the EOB. That site is at [PII].
[AGENT][NEUTRAL] And what is the fax number?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] Thank you so much for that. Appreciate it. Fax number would be [PII]. Attention to my name, [PII].
[AGENT][NEUTRAL] OK, and that fax number is [PII].
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, is there anything else, [PII], I can assist you with today?
[CUSTOMER][NEUTRAL] Can you please spell your name for me?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much for that, OK. And can I get the call reference number?
[AGENT][NEUTRAL] You may use my name with today date.
[CUSTOMER][POSITIVE] Thank you so much [PII]. Thank you so much for your help. You have a great day. Bye for now.
[AGENT][NEUTRAL] Mhm. Thank you for calling APL. Bye.