AccountId: 011433970860
ContactId: 3570d515-7975-4e64-9193-b03d6060dc5b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 506799 ms
Total Talk Time (AGENT): 162760 ms
Total Talk Time (CUSTOMER): 194878 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/3570d515-7975-4e64-9193-b03d6060dc5b_20241230T18:03_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi. I'm calling from.
[AGENT][NEUTRAL] OK, I can barely hear you.
[CUSTOMER][NEUTRAL] Uh hello. I'm not.
[AGENT][POSITIVE] That's a little better.
[AGENT][NEUTRAL] Do you have me on speaker phone?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, can you take me off the speaker phone because I can barely hear you.
[CUSTOMER][NEUTRAL] OK, fine. I'm audible.
[AGENT][NEUTRAL] OK, that's better. Your name?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII].
[AGENT][NEUTRAL] And [PII], you said you're checking a claim status?
[CUSTOMER][NEUTRAL] Yes. And uh could you please spell your name once again?
[AGENT][NEUTRAL] And that policy number?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, and could you please spell your name once again?
[AGENT][NEUTRAL] Oh, [PII], first initial last name is [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And that policy number?
[CUSTOMER][NEUTRAL] Yeah, sure, just a moment.
[CUSTOMER][NEUTRAL] It's 248-565-1.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. It's um [PII] with the [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mm it's 2.
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It's uh [PII]. Sorry.
[AGENT][NEUTRAL] OK, and you said that you're checking uh claim status we can assist with that information. What's the date of service and the total bill charge?
[CUSTOMER][NEUTRAL] Mm, it's [PII] for the bill amount $403.46.
[AGENT][NEUTRAL] 403.46.
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what's the procedure code on the claim or codes on the claim?
[CUSTOMER][NEUTRAL] Mm, that's a postal code. Uh, the line one is 99213 and the line to CPT is 36415.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Were those the only codes on the claim?
[CUSTOMER][NEUTRAL] Sorry, what?
[AGENT][NEUTRAL] Were those the only two codes on the claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I don't show that claim received.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You gave me the 99213 and the 36415?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I don't show that we've received that claim for [PII].
[CUSTOMER][NEUTRAL] There is no payment for, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Shall I know the patient's eligibility here?
[AGENT][NEUTRAL] Mhm, the policy effective date.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And currently I show the policy is active.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So I have the claim number change conference number.
[AGENT][NEUTRAL] My name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm, I have a same patient for the another date of service. So will you please check with that.
[AGENT][NEUTRAL] OK, how many dates of service do you have for this patient?
[CUSTOMER][NEUTRAL] Hi, uh, I have a totally 6, data service for this patient.
[AGENT][NEUTRAL] OK, I can do one more and then I can show you how to create an online account to check your statuses. What's the next date of service?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And the amount?
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] It's the same amount of 403.46.
[AGENT][NEUTRAL] Same procedure codes?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Let me check here.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, uh for the same CPT.
[AGENT][NEUTRAL] OK, I do not show that date of service received for those codes.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Are the other dates of service the same, same amount same codes?
[CUSTOMER][NEUTRAL] Mm, no, it's a different data service under different bill amount.
[AGENT][NEUTRAL] What are the codes the same?
[CUSTOMER][NEUTRAL] Mm, pet code it's a different, different, different postal code. It's [PII].
[AGENT][NEUTRAL] OK, do you wanna go ahead and set up an online account?
[CUSTOMER][NEUTRAL] Mm, I'm having a little bit of time uh so I can't able to.
[CUSTOMER][NEUTRAL] Process the provider portal actually here.
[AGENT][NEUTRAL] Could you repeat what you just said?
[CUSTOMER][NEGATIVE] I don't have the time to uh create a portal from the from your end.
[CUSTOMER][NEUTRAL] Um, will you please give me a case status over the phone call because I'm having a 4 more or different data service actually.
[AGENT][NEUTRAL] For the same per for the same person?
[CUSTOMER][NEUTRAL] Yes, for the same first.
[AGENT][NEUTRAL] OK, did I understand you to say that you did not have time to create an account?
[CUSTOMER][NEUTRAL] Yes, actually, so that.
[AGENT][NEUTRAL] OK, what's the next date of service?
[CUSTOMER][NEUTRAL] Thank you. It's uh [PII] for the bill amount 472.96.
[AGENT][NEUTRAL] In the amount?
[AGENT][NEUTRAL] The procedure codes?
[CUSTOMER][NEUTRAL] It's 99214 and 36415.
[AGENT][NEUTRAL] So the same codes, I don't show that claim on file. There are no claims on file with those procedure codes.
[CUSTOMER][NEUTRAL] Thank you. Um, shall we move to the next data service here?
[AGENT][NEUTRAL] Is it for the same procedure codes, [PII], because if it is, I've already looked through their history. If it's for the 99213 or 21436415, I do not show those claims on any of the charges rece those procedure codes on any of the claims received.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] So is it for the two same procedure codes?
[CUSTOMER][NEUTRAL] Fine.
[CUSTOMER][NEUTRAL] Yeah, I got it. Um.
[CUSTOMER][NEUTRAL] check you.
[CUSTOMER][NEUTRAL] Um, do you have the uh CPD for 98966?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, so let me check the data service here, um.
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] I don't show any claims for that date of service. What were the how did you submit your claims?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] To electronic image.
[AGENT][NEUTRAL] Yeah, where, where, how were they submit it by mail, electronically, fax? How did you submit the claims?
[CUSTOMER][NEUTRAL] It's, it's electronically. It's uh pay ID is 42011. Is that correct?
[AGENT][NEUTRAL] You said electronically?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what payer ID number was used?
[CUSTOMER][NEUTRAL] It's 42011.
[AGENT][NEUTRAL] OK, so the payer ID number is 64556.
[CUSTOMER][NEUTRAL] 645-556, got it.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] Is there any timely willing to listen with the claim?
[AGENT][NEGATIVE] There is no timely filing to submit a claim.
[CUSTOMER][POSITIVE] Thank you, thank you, [PII]. Thanks for assisting me.
[AGENT][POSITIVE] You're welcome. Anything else I can help with today?
[CUSTOMER][POSITIVE] Mm, nothing, not it. Thank you.
[AGENT][POSITIVE] OK, [PII], thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Have a good day. Bye. You too.