AccountId: 011433970860
ContactId: 50d843b0-e228-4c85-b1d4-a312eecd2334
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1005989 ms
Total Talk Time (AGENT): 179818 ms
Total Talk Time (CUSTOMER): 221359 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/50d843b0-e228-4c85-b1d4-a312eecd2334_20250430T18:37_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Where are you calling on behalf of the provider's office to check on claim status. Could you please help me with that?
[AGENT][NEUTRAL] Yes, I can help you with claim status. I've missed your name. What was your name?
[CUSTOMER][NEUTRAL] It is [PII]
[AGENT][NEUTRAL] OK, do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] The policy number that is 608817.
[AGENT][NEUTRAL] And do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Get the service for the claim that is for.
[CUSTOMER][NEUTRAL] [PII], bill amount $1,036.
[AGENT][NEUTRAL] OK, I'm sorry. Will you give me that date again? March?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, it looks like we received that on [PII]. Process [PII].
[AGENT][NEUTRAL] We made a payment of 128.
[CUSTOMER][NEUTRAL] You want 28 on?
[CUSTOMER][NEUTRAL] Do it again.
[AGENT][NEUTRAL] Uh, that was on, get back to that screen.
[AGENT][NEUTRAL] 325, 25.
[CUSTOMER][NEUTRAL] 25. OK, then, so is it paid through check or EFT?
[AGENT][NEUTRAL] A single check.
[CUSTOMER][NEUTRAL] Can I have the check number?
[AGENT][NEUTRAL] 2034865.
[CUSTOMER][NEUTRAL] 030865. OK. And then can I have the address that the check was sent to?
[AGENT][NEUTRAL] OK, hold on just a second.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And I have the patient responsibility?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me pull up the EOB.
[AGENT][NEUTRAL] Uh, patient responsibility is.
[AGENT][NEUTRAL] Well, we paid 128, so whatever is left over, so the balance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, OK, 128. So the 1110 and the postal code is 2392. Was it paid?
[AGENT][NEUTRAL] Uh, $12 went towards the deductible.
[AGENT][NEUTRAL] 335 is the patient responsibility for that code.
[CUSTOMER][NEUTRAL] 3:35, OK.
[CUSTOMER][NEUTRAL] Can, uh, but yes. How about for the 2392? Was it paid or not?
[AGENT][NEUTRAL] That's the one you just asked about?
[AGENT][NEUTRAL] You just said 23
[CUSTOMER][NEUTRAL] Uh, the, no, I, you pro
[CUSTOMER][NEUTRAL] Yes. How about the 11:10?
[AGENT][NEUTRAL] Patient responsibility is 97.
[CUSTOMER][NEUTRAL] But then it was paid, right?
[AGENT][NEUTRAL] We paid 59.
[AGENT][NEUTRAL] On that coast.
[CUSTOMER][NEUTRAL] OK. So can you please help me verify? You said how much deductible is applied under this claim?
[AGENT][NEUTRAL] 50
[CUSTOMER][NEUTRAL] 50 and what will be the yearly deductible?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Will be the yearly deductible.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] The 50 is the you.
[CUSTOMER][NEUTRAL] Oh, what? 5? OK. Can you please help me verify the remaining would be 0. OK. Can I have the claim number?
[AGENT][NEUTRAL] The claim number is 358-0528.
[CUSTOMER][NEUTRAL] Can you please help me with the
[CUSTOMER][NEUTRAL] Copy of EOB through fax.
[AGENT][NEUTRAL] OK, what's your facts?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'll get that faxed over. It just takes about 5 minutes.
[CUSTOMER][NEUTRAL] OK then, so can you please help me with the reference number and we'll move on to the next patient.
[AGENT][NEUTRAL] Reference number is my name and today's date.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah, we'll move on to the next one.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] OK, and the next policy number?
[CUSTOMER][NEUTRAL] The next policy number, that is
[CUSTOMER][NEUTRAL] 02588837
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name that will be [PII], [PII].
[AGENT][NEUTRAL] Day of service and bill charges.
[CUSTOMER][NEUTRAL] The service that will be in [PII]. Charges amount it is $1,127.
[AGENT][NEUTRAL] Received on [PII].
[AGENT][NEUTRAL] Paid on [PII].
[AGENT][NEUTRAL] Payment was 2:45.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, then so can you please help me with the check number?
[AGENT][NEUTRAL] Number 203-273-2.
[CUSTOMER][NEUTRAL] Single check as well?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And so, to which address?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. And have the patient responsibility. Uh, just to confirm, the by wings and the exams was all paid on this claim, no deductible applied or does it apply?
[AGENT][NEUTRAL] Do you need the EOB that will show the breakdown.
[CUSTOMER][NEUTRAL] Yeah, sure, sure, sure.
[AGENT][NEUTRAL] Faxed to the same number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And do you have online access to our online portal?
[AGENT][NEUTRAL] You can print EOP immediately from there.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, sure. Then can I have the claim number?
[AGENT][NEUTRAL] 357-3782.
[CUSTOMER][NEUTRAL] And just to confirm the um quote that I mentioned, the right wings and the exam will spread right and the this clip.
[AGENT][NEUTRAL] Yes, those were considered under the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, then so we'll move on to the next patient.
[AGENT][NEUTRAL] Do you have access to our online portal? How many claim statuses do you have?
[CUSTOMER][NEUTRAL] I have 2 more.
[AGENT][NEUTRAL] OK, do you have access to the internet?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] OK. And the policy number?
[CUSTOMER][NEUTRAL] 02518124.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] There's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And data service and bill charges?
[CUSTOMER][NEUTRAL] Yeah, the service for the claim, that'll be for [PII].
[AGENT][NEUTRAL] OK, it looks like we had denied the claim and the services are not covered under the policy.
[AGENT][NEUTRAL] And that claim was received on.
[CUSTOMER][NEUTRAL] Services
[AGENT][NEUTRAL] [PII] 18 2025 and denied 226, 2025.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 226. OK, then, so,
[CUSTOMER][NEUTRAL] What will be the patient responsibility is it the total bill amount?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, then so can I please, can you please help me with the claim number?
[AGENT][NEUTRAL] 356-8408.
[CUSTOMER][NEUTRAL] OK. And can you send me the copy of UB for this one as well?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK then. So whenever you're ready, we'll move on to the last patient.
[AGENT][NEUTRAL] Getting it faxed. Give me just one moment.
[AGENT][NEUTRAL] OK, the policy number?
[CUSTOMER][NEUTRAL] Policy number that'll be 2344896.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII], [PII].
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] That is on [PII] 25 bill amount $258.
[AGENT][NEUTRAL] Uh, it looks like we received that claim on 3-26-25, process 4-2-2025. Policy terminated [PII]. It was denied for services after terminate.
[CUSTOMER][NEUTRAL] OK then so is this individual or a group domination?
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Is it a group or individual combination?
[AGENT][NEUTRAL] Um, individual.
[CUSTOMER][NEUTRAL] September date is [PII]. Can I have the pro uh the
[CUSTOMER][POSITIVE] Plan effectively.
[AGENT][NEUTRAL] Uh, effective date was.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Your termination. Can I have the claim number?
[AGENT][NEUTRAL] 3583733.
[CUSTOMER][POSITIVE] So thank you so much [PII], for your time and your help. I really appreciate it. I hope you have a good day ahead. Thank you so much.
[AGENT][POSITIVE] Thank you for calling APL. I hope you do too. Bye-bye.