AccountId: 011433970860
ContactId: 41637f28-abb6-48cd-97bd-a585f903781e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286410 ms
Total Talk Time (AGENT): 65604 ms
Total Talk Time (CUSTOMER): 72681 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/41637f28-abb6-48cd-97bd-a585f903781e_20250625T14:48_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, yes, ma'am, I just wanted to check, um, claim status for, um, a single data service, and I don't know if I pressed the right option or not either.
[CUSTOMER][NEUTRAL] So I don't even know if you're the one that would help me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I can help you with claim status. Could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The number is [PII] [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. And do you have the policy number for the patient?
[CUSTOMER][NEUTRAL] Um, yes, I have 02510727.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] 6762.
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Data service is 102124. Total bill for the claim is 364, and I think.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Can you pull up with that?
[AGENT][NEUTRAL] Uh, I've got several charges for that date. Do you have a CPT code you could provide?
[CUSTOMER][NEUTRAL] The total bill?
[CUSTOMER][NEUTRAL] 971-40.
[CUSTOMER][NEUTRAL] 97,110.
[CUSTOMER][NEUTRAL] 97112.
[CUSTOMER][NEUTRAL] And 97014 for that date.
[AGENT][NEUTRAL] OK, let me see, we received it several times. Let me see.
[AGENT][NEUTRAL] OK, it looks like it was originally received in December [PII] process [PII].
[AGENT][NEUTRAL] Looks like, so benefits are only payable if major medical insurance provides benefits.
[AGENT][NEUTRAL] Claim is later paid, please send EOB showing benefits were paid.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You know, um, when was it corrected.
[CUSTOMER][NEUTRAL] So at no point you've gotten the EOB.
[AGENT][NEGATIVE] We received the EOB but it didn't show anything was paid or allowed. Do you, do you have an EOB that shows that?
[CUSTOMER][NEUTRAL] Let's see
[AGENT][NEUTRAL] Let me pull up what we received.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Because it looks like we received the AMed EOB.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it said,
[AGENT][NEUTRAL] For each charge, remaining patient liability 0.
[CUSTOMER][NEUTRAL] Let me see if I can pull up her up.
[AGENT][NEUTRAL] I see an adjustment reason previously paid.
[CUSTOMER][MIXED] OK, yeah, so no, they didn't, yeah, no, they didn't pay it, they went to patient responsibility and all of that, OK, in which case then you guys wouldn't do it. That's fine. I guess I should have looked a little harder.
[AGENT][NEUTRAL] Oh, that's OK.
[CUSTOMER][POSITIVE] All right, well, thank you.
[AGENT][POSITIVE] OK, thanks for calling APL. Hope you have a good day.
[CUSTOMER][NEUTRAL] You too bye.