AccountId: 011433970860
ContactId: 3a903c5a-7101-4fff-8ab2-2d54e4243c82
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 301899 ms
Total Talk Time (AGENT): 113136 ms
Total Talk Time (CUSTOMER): 107095 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/3a903c5a-7101-4fff-8ab2-2d54e4243c82_20250623T15:28_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] calling from provider's office to check on claim status. Could you help me with that, please?
[AGENT][NEUTRAL] Sure, I can assist you with claim status, Mr. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, uh, it's [PII].
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from from my note?
[CUSTOMER][NEUTRAL] Yes, uh, we are calling from GE Health Integrated Practice INC.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah. It's 1,119,240.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Patient's last name is uh [PII] and the first name is [PII].
[AGENT][NEUTRAL] OK. What's the date of birth?
[CUSTOMER][NEUTRAL] Uh, it's on [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEGATIVE] Uh, so, actually, for this one, we have received a denial and the data service I have here is uh [PII], the total bill amount of $70 even.
[AGENT][NEUTRAL] OK, you said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] One a month.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, and that was for $70. What is the procedure code?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh, we have built, uh, two procedures, uh, which is 73 I mean two times, which is 73,030 and 73,030 with the different modifiers.
[AGENT][NEUTRAL] OK, thank you. OK, yes, um, it looks like we deny stating that the records indicate that the premium for the data service was not received. Therefore benefits are not payable. Now the policy's been terminated.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Can I know the termination date?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] The termination date on this one is [PII].
[CUSTOMER][NEUTRAL] Oh, OK. So, uh, are you the primary for the member?
[AGENT][NEUTRAL] This is a limited hospital indemnity policy.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So are there any other active insurance for the member for the data service?
[AGENT][NEGATIVE] Not with us.
[CUSTOMER][NEUTRAL] You don't have information on that?
[AGENT][NEUTRAL] Mm, we don't have any other policies available for this number.
[CUSTOMER][NEUTRAL] OK. So you are the primary, is that right?
[AGENT][NEUTRAL] We are the, this is a limited hospital indemnity plan. So um we don't know if they have any other um policies out there, but this is just a limited plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK. Can I have the claim number for this?
[AGENT][NEUTRAL] All right. And the claim number is 3593952.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 3952. Got that. And uh so I have another claim it's for the same number and uh so it might be the, uh, we have received the same reason. I just need the claim number for this and uh I can provide you the date of service.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] And you said it's for the same member?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, what is the date of service?
[CUSTOMER][NEUTRAL] Uh, it's on [PII]. The total bill amount of $438 even. I just need the claim number. It's the same denial reason we issued.
[AGENT][NEUTRAL] OK. Uh, and that is for code 99203.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. So the claim number on this one is 3595538.
[CUSTOMER][NEUTRAL] OK, got that. And can I have the call reference number for this?
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's name.
[CUSTOMER][NEUTRAL] You don't
[CUSTOMER][NEUTRAL] How can I spell your name?
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][POSITIVE] Thanks, so that's all I need from you today. Thank you for assisting me today, and yeah, enjoy the rest of your day. Bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you for calling APL. Bye-bye.