AccountId: 011433970860
ContactId: 527e6f85-3715-46a7-90b9-b3163db9a3a7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 531059 ms
Total Talk Time (AGENT): 169930 ms
Total Talk Time (CUSTOMER): 133926 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/527e6f85-3715-46a7-90b9-b3163db9a3a7_20250522T16:19_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII] here calling from provider's office to check on claim status.
[AGENT][NEUTRAL] What is your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And your callback number?
[CUSTOMER][NEUTRAL] [PII] with extension of [PII].
[AGENT][NEUTRAL] What is the policy number? Thank you.
[CUSTOMER][NEUTRAL] Yes, before you proceed, I'll let you know this call will be recorded for quality and training purpose.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] The member ID number is 025578885.
[AGENT][NEUTRAL] OK. I have that as 025578885. Thank you. Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] and the date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you so much for that verification. You're calling for claim status. I can help you, and you can also check claim status by visiting our secure portal at [PII]. And if you need an EOB that can be obtained on that website as well. What's that that will start in the total charge amount?
[CUSTOMER][NEUTRAL] [PII] and the amount is $1,079 even.
[AGENT][NEUTRAL] OK, I have it as [PII] $1,079 even. One moment, please.
[AGENT][NEUTRAL] OK, was this a professional charge or a facility?
[CUSTOMER][NEUTRAL] Facility.
[AGENT][POSITIVE] OK, facility, right, thank you so much for that.
[AGENT][NEUTRAL] OK, I did not show a facility charge for that date of service and that total charge amount.
[CUSTOMER][NEUTRAL] Mhm. Could you please repeat again?
[AGENT][NEUTRAL] I did not show a facility charge for the date of service of [PII] for $1,079.
[CUSTOMER][NEUTRAL] I'm calling from the provider's office.
[AGENT][NEUTRAL] So it's a professional, not facility, OK, one moment.
[CUSTOMER][NEUTRAL] Yes, yes, yes. Yeah, yeah.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] 73.
[AGENT][NEUTRAL] OK, thank you so much for your patience. It shows that the claim was received on [PII] and processed on [PII]. Let me get that payment information for you. One moment.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] May I place you on hold, please?
[CUSTOMER][NEUTRAL] May I please
[CUSTOMER][NEUTRAL] Yeah, but as I said, uh, previously.
[CUSTOMER][NEUTRAL] Uh, claim container as uh for the primary OV so we already send the primary OV.
[AGENT][NEUTRAL] OK, well, I'm gonna place you on hold, OK? One moment please. Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, thank you so much for your patience, [PII]. I was able to locate that claim. We made a payment in the amount of $595.30.
[CUSTOMER][NEUTRAL] OK, is there any patient responsibility?
[AGENT][NEUTRAL] Um, APL does not determine patients responsibility.
[CUSTOMER][NEUTRAL] OK, could you confirm me the claim number?
[AGENT][NEUTRAL] 357-7083
[CUSTOMER][NEUTRAL] 7570083, correct?
[AGENT][NEUTRAL] 357-7083.
[CUSTOMER][NEUTRAL] OK, there is a PTR, right? I just want to confirm one more last time.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Is there any patient responsibility?
[AGENT][NEUTRAL] APL does not determine patients responsibility.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, is it your on security code [PII] 1st line CPT code. We didn't get the payment on that security code. Could you please confirm me the status for that?
[AGENT][NEUTRAL] OK, for 76816 we made a payment of $344.43 and again for 76816 we made a payment of $250.87.
[CUSTOMER][NEUTRAL] OK, so could you please send me the again the uh paid amount for first line card because I not received any payment for that.
[CUSTOMER][NEUTRAL] 768165.
[AGENT][NEUTRAL] 476-816.
[AGENT][NEUTRAL] Is there a modifier?
[CUSTOMER][POSITIVE] Yes, without modifier, yes.
[AGENT][NEUTRAL] OK, without modifier, we made 3 44 43.
[CUSTOMER][NEUTRAL] And with modifier?
[AGENT][NEUTRAL] $250.87.
[CUSTOMER][NEUTRAL] Could be for when was uh pay date.
[AGENT][NEUTRAL] OK, the claim was paid [PII].
[CUSTOMER][NEUTRAL] EFT EFT or check.
[AGENT][NEUTRAL] Single paper check.
[CUSTOMER][NEUTRAL] from the check number.
[AGENT][NEUTRAL] 203-3726
[CUSTOMER][NEUTRAL] 2033726, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Could just confirm the check issue and clear it.
[AGENT][NEUTRAL] OK, issued on [PII], cleared [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, I have one more on our claim for the same patient but different data service, so could you please help me with that also.
[AGENT][NEUTRAL] Sure, what is the day of service and total charge amount?
[CUSTOMER][NEUTRAL] Yeah, I'll check. Just give me 30 seconds.
[CUSTOMER][NEUTRAL] Mm, no, uh, that's it. Uh, one of our process already processed that claim. OK, thank you so much. Could you please provide me the call reference number?
[AGENT][NEUTRAL] You're welcome. We don't call reference numbers. You can use my name [PII] last initial [PII] in today's date. Anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh, could you please fax the paid UV.
[AGENT][NEUTRAL] OK, you're able to obtain that you'll be from the website at [PII], but I will fax it over to you. What is your fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me just make sure I have that correct, OK. I have that as [PII].
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] OK, anything else I can help you with, please?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Take care bye.
[CUSTOMER][NEUTRAL] Bye.