AccountId: 011433970860
ContactId: 442cc5a8-e91c-43f3-ab74-0826e20865f9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 245300 ms
Total Talk Time (AGENT): 63888 ms
Total Talk Time (CUSTOMER): 126494 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/442cc5a8-e91c-43f3-ab74-0826e20865f9_20250319T16:32_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] calling from the provider's office regarding claims information. How are you doing today?
[AGENT][NEUTRAL] I'm doing fine. How are you? Do you have a callback number I can get?
[CUSTOMER][NEUTRAL] Sure, before I proceed, I informed that the call is being recorded for the call entering purposes. Would you like to continue recording.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Thank you. The callback number is [PII]. It is direct call line.
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Sure, the policy number is 021-61325.
[AGENT][NEUTRAL] Thank you. Hold on one moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] So the patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you are needing claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can look that up for you. What date of service?
[CUSTOMER][NEUTRAL] It is [PII] for the bill amount is $504 even $504 even.
[AGENT][NEUTRAL] What is the bill amount?
[CUSTOMER][NEUTRAL] It is $504 504 dollars even.
[AGENT][NEUTRAL] And what's the procedure code?
[CUSTOMER][NEUTRAL] The procedure code it is one moment.
[CUSTOMER][NEUTRAL] Yeah it is.
[CUSTOMER][NEUTRAL] 99214 the procedure for.
[AGENT][NEUTRAL] OK, I have that data service.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] With that procedure code, but I don't have that amount.
[CUSTOMER][NEUTRAL] Yeah, the procedure bill amount is $277 even $277 even. I'm telling the whole amount.
[AGENT][NEUTRAL] I thought you said 504.
[CUSTOMER][NEUTRAL] No, I'm selling the whole bill amount, but the particular CPT is $277 even.
[AGENT][NEGATIVE] OK, 277, we do have, it was denied. Office visits are not covered.
[CUSTOMER][NEGATIVE] Offices are not covered. So why office it is not because it has primary process BCBS and bill to secondly like uh American public. So primary process, so secondary also process know why it is denied it is not covered office visit.
[AGENT][NEUTRAL] No, I.
[AGENT][NEUTRAL] Office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, coffee is not on the policy.
[AGENT][NEUTRAL] No matter what the major medical pays, it's not covered under our policy.
[CUSTOMER][NEUTRAL] No just
[CUSTOMER][NEUTRAL] OK, so it is me is available for the charger, this one?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so member is liable. OK. And [PII], uh, we don't have this UB, so could you please fax the UB to us? So when you are ready I will provide you the fax number.
[AGENT][NEUTRAL] What's the fax number?
[CUSTOMER][NEUTRAL] Yeah, it is [PII]. I repeat, [PII]. Attention to my name, [PII].
[AGENT][NEUTRAL] OK, I'll fax it to you.
[CUSTOMER][NEUTRAL] OK. Uh, within how many days it will, uh, how many are will be received?
[AGENT][NEUTRAL] Within the next hour.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And could you please provide me the call reference number?
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name and today's date.
[CUSTOMER][POSITIVE] OK, [PII], thank you so much for information. Have a great day. Bye-bye. Stay safe.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day as well. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.