AccountId: 011433970860
ContactId: 3506bbb3-5864-4b52-865e-a3dfdc998a45
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 312470 ms
Total Talk Time (AGENT): 114106 ms
Total Talk Time (CUSTOMER): 124175 ms
Interruptions: 2
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/3506bbb3-5864-4b52-865e-a3dfdc998a45_20250321T19:51_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status, Ms. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Yeah, sure, the callback number it's [PII] and the extension is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, sure. Patient's policy number it's 021.
[CUSTOMER][NEUTRAL] 73604.
[AGENT][NEUTRAL] OK, what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, my first name is [PII] and date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yes, and the date of service is [PII] and the total charge amount of $157 even.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, that was [PII] for 157. What is the procedure code?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The procedure code it's 99213.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] G 2211.
[CUSTOMER][NEUTRAL] 3880 F. mhm we bill for 5 district codes. Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That's good.
[AGENT][NEUTRAL] Yeah, it's fine. Yeah, I just needed to know if this is it, OK, uh, one moment, let me pull the EOB, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] What's the bonding. What's the bonding.
[AGENT][NEUTRAL] Still waiting on the AOB one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. So it looks like we processed this claim on [PII].
[AGENT][NEUTRAL] And let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] The office visited is not covered under the member's plan and it looks like the only one that paid was um the G.
[AGENT][NEUTRAL] Um, 2211.
[AGENT][NEUTRAL] Which was 2 cents.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You said, uh, the G2211 is pay?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] May I know the paid amount for that one?
[AGENT][NEUTRAL] That one it was 2 cents.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it's not covered under by the patient plan, right?
[AGENT][NEUTRAL] The office visit is not covered under the member's plan, correct?
[CUSTOMER][NEUTRAL] Yeah, uh, yeah, OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So for this one we can send a secondary or um can be patient for this one.
[AGENT][NEUTRAL] It's up to the provider's discretion. We have no contractual involvement on the remaining of the claim. We're just the secondary policy.
[CUSTOMER][NEUTRAL] OK, could you please spell your name for me?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure. My name is [PII]. That's [PII], last initial [PII].
[CUSTOMER][NEUTRAL] OK, thank you so much. And can you please uh tell me the receipt date for this time? sorry I missed to ask that.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, sure, let me go ahead and go back to that.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Sorry for that.
[AGENT][NEUTRAL] It's OK, no problem. Uh, let's see, 861 it was received on [PII].
[CUSTOMER][POSITIVE] OK, [PII], thank you so much. So yeah, and can I get the call reference for this call now?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling or any other information?
[CUSTOMER][POSITIVE] Um, no, I got it. So thank you so much for me today. Happy weekend.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] You're welcome. You as well. Thank you for calling APL. Have a good day, Mr. [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye, bye bye.
[AGENT][NEUTRAL] Bye bye.