AccountId: 011433970860
ContactId: 55f268db-b000-4422-87fa-23a5087c53f8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 901630 ms
Total Talk Time (AGENT): 247010 ms
Total Talk Time (CUSTOMER): 397240 ms
Interruptions: 8
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/55f268db-b000-4422-87fa-23a5087c53f8_20250617T17:44_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] calling on behalf of product office regarding claim status. How are you doing today?
[AGENT][POSITIVE] I'm good, thank you. How about you?
[CUSTOMER][POSITIVE] Yeah, thank you for asking so much. I'm good.
[AGENT][NEUTRAL] Good. May I have the spelling of your name?
[CUSTOMER][NEUTRAL] Could you please spell your name?
[CUSTOMER][NEUTRAL] Yeah. It's [PII]. [PII].
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] Good, yeah.
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected? Mhm. Yes.
[CUSTOMER][NEUTRAL] Yeah, name is so.
[CUSTOMER][NEUTRAL] Yeah, it is uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm OK. And no extension.
[CUSTOMER][NEUTRAL] No extension it's a direct line.
[AGENT][NEUTRAL] OK, and what is the name of the facility you're calling from, Mr. [PII]?
[CUSTOMER][NEUTRAL] It's Asander.
[AGENT][NEUTRAL] I see, OK.
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, of course, it is 0208.
[CUSTOMER][NEUTRAL] 78
[CUSTOMER][NEUTRAL] 85
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Name is [PII].
[CUSTOMER][NEUTRAL] And Buddhist
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Right. And you say you need claim status. What is the date of service?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] You say it's [PII].
[AGENT][NEUTRAL] OK. Are you looking for a specific procedure code?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, of course. There are procedure codes, specific procedure codes are there. Can I tell the procedure codes?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Yeah, it is, uh, first one is 4381.
[CUSTOMER][NEUTRAL] OK. Uh, the tooth number is, yeah, just a minute.
[CUSTOMER][NEUTRAL] For this, the number is 06.
[CUSTOMER][NEUTRAL] And the another one is 4921.
[CUSTOMER][NEUTRAL] To number is
[CUSTOMER][NEUTRAL] LR
[CUSTOMER][NEUTRAL] The another one is 7140.
[CUSTOMER][NEUTRAL] The number is 19.
[CUSTOMER][NEUTRAL] And the another one is 4381.
[CUSTOMER][NEUTRAL] 231.
[CUSTOMER][NEUTRAL] Another one is 0210.
[CUSTOMER][NEUTRAL] There's no tooth number.
[CUSTOMER][NEUTRAL] And the other one is 4381.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] The two number is this the 30.
[CUSTOMER][NEUTRAL] Another one is also same 4381.
[CUSTOMER][NEUTRAL] Yeah, tell me, are you, are you willing to tell something?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Excuse me, I'm sorry. OK. Um, yes.
[CUSTOMER][NEUTRAL] It's OK, it's OK.
[AGENT][NEUTRAL] Um, bear with me.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, uh, this procedure codes, it's 9630, no procedure code, sorry, no 2.
[CUSTOMER][NEUTRAL] Um, and then another one is 4381. The number is 28.
[CUSTOMER][NEUTRAL] The other one is also same 4381.
[CUSTOMER][NEUTRAL] To number is 26.
[CUSTOMER][NEUTRAL] The other one is 4381.
[CUSTOMER][NEUTRAL] Truth number is 27. Began to end um.
[CUSTOMER][NEGATIVE] The another one is 0150, no truth number as given. Only two more codes, 4341.
[CUSTOMER][NEUTRAL] To number is LR.
[CUSTOMER][NEUTRAL] Um, the last one is 4381. The number is 08. Sorry, uh, could you please tell me the
[CUSTOMER][NEGATIVE] Denied reason for these codes.
[AGENT][NEUTRAL] OK, there's not a denial reason we send the payment.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Um, what is the total charge amount? Do you have that amount?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, the total charge amount for this claim is $1,729.
[AGENT][NEUTRAL] OK. Right, so it looks like we send a benefit amount of $855.80 to the provider.
[CUSTOMER][NEUTRAL] So, yeah, yeah. Tell me 800 and?
[AGENT][NEUTRAL] $855.80.
[CUSTOMER][NEUTRAL] 800
[CUSTOMER][NEUTRAL] $65 right?
[AGENT][NEUTRAL] 80555555.80.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 55.80, right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I need the procedure code 43812 number 06. It's paid means could you please tell me the patient responsibility?
[AGENT][NEUTRAL] OK. So let's see.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, looks like $50 of that amount was applied towards the deductible. So there is a patient's responsibility of $85.40.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] $85.40. OK. Uh, could you please tell me the allowed amount for the code?
[AGENT][NEUTRAL] The loan amount.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah, tell me.
[AGENT][NEUTRAL] One moment, I'll have to add this together, one moment.
[CUSTOMER][NEUTRAL] I'll have to add
[CUSTOMER][POSITIVE] OK, take your time.
[AGENT][NEUTRAL] OK, so the charge amount is $109 and the allowed amount is $109 because we pay $23.60 and $85.40 went to the members responsibility because of that deductible and we only pay 40%.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] That's $85 in points and deductible and we only pay 40.
[CUSTOMER][NEUTRAL] Yeah, but, but the patient responsibilities, uh, could you please send me the patient responsibility for the code 438126 once again.
[AGENT][NEUTRAL] $85.40.
[CUSTOMER][NEUTRAL] OK, OK, OK. Sorry. Um, uh, could you please uh tell me the another code 49212 number LR patient responsibility.
[AGENT][NEUTRAL] OK, what is the code again?
[CUSTOMER][NEUTRAL] It's 43, sorry, it's 4921.
[AGENT][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] 2 number 1R.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so that one, the patient's responsibility is the full amount, which is the $20.
[CUSTOMER][NEUTRAL] Both numbers and as.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That one is not payable under this policy. Mhm.
[CUSTOMER][NEUTRAL] $20
[CUSTOMER][NEUTRAL] It's $20 right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Could you please tell me the allowed amount for this code?
[AGENT][NEUTRAL] $20.
[CUSTOMER][NEUTRAL] It's $20.
[AGENT][NEGATIVE] There is no paid amount because it's not covered under the policy.
[CUSTOMER][NEUTRAL] No payment. OK.
[CUSTOMER][NEUTRAL] Not covered under the policy, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, just a minute.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Not cover.
[CUSTOMER][NEUTRAL] OK. Uh, could you please tell me the 71402 number 19 paid amount? Sorry, patient responsibility.
[AGENT][NEUTRAL] $22.20.
[CUSTOMER][NEUTRAL] $42.20 right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Uh, could you please tell me the allowed amount for this?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, when you say the allowed amount, are you meaning the one we paid or what is um what are you asking about the allowed amount?
[CUSTOMER][NEUTRAL] The, the, the amount which they allowed to pay the amount. That's what I'm asking.
[AGENT][NEUTRAL] The amount that we paid, which that is what we pay, 16,880 is the amount we pay.
[CUSTOMER][NEUTRAL] 168
[AGENT][NEUTRAL] 80.
[CUSTOMER][NEUTRAL] 80.
[CUSTOMER][NEUTRAL] Yeah, just a minute.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 168, right?
[AGENT][NEUTRAL] Yes, $168.80.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Could you please tell me the 4381 to number 31 patient responsibility?
[AGENT][NEUTRAL] OK, the patient's responsibility for 4381 for 231 is $65.40.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. Allow the month.
[AGENT][NEUTRAL] Paid amount is $43.60.
[CUSTOMER][NEUTRAL] 60 cents.
[CUSTOMER][NEUTRAL] $43.60.
[CUSTOMER][NEUTRAL] It's, this is the amount which they paid, right?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] That the amount we paid.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Could you please tell me the 0210 uh.
[CUSTOMER][NEGATIVE] Paid month.
[CUSTOMER][NEUTRAL] Patient responsibilities, sorry.
[AGENT][NEUTRAL] OK, so that's um you said 0210?
[CUSTOMER][NEUTRAL] Ok, so that's um.
[CUSTOMER][POSITIVE] Yes, of course.
[AGENT][NEUTRAL] OK, that is patience responsibility, $31.40.
[CUSTOMER][NEUTRAL] OK. Uh, and the allowed amount?
[AGENT][NEUTRAL] Paid amount is $125.60.
[CUSTOMER][NEUTRAL] She must
[AGENT][NEUTRAL] Mr. [PII], I can also send you a copy of that of this EOB if you need it.
[CUSTOMER][NEUTRAL] Yeah. Uh, OK. You'll be sending the copy of.
[AGENT][NEUTRAL] It has all the amount that you're asking me.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, uh, just a minute. Give me a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, could, could you please send me the EUB, the UPS?
[AGENT][NEUTRAL] OK, um, what is the fax number?
[CUSTOMER][NEUTRAL] Yeah, um, the fax number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Yes, of course.
[AGENT][NEUTRAL] To your attention.
[CUSTOMER][NEUTRAL] insurance
[CUSTOMER][NEUTRAL] Yes, tell me.
[AGENT][NEUTRAL] Is it gonna be to your attention?
[CUSTOMER][NEUTRAL] Yes, it's a private, private.
[AGENT][NEUTRAL] So I'm gonna send it with your name, so to your attention, to Glade.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, that's 3254173.
[AGENT][NEUTRAL] I'm waiting on the system, bear with me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, are you there?
[AGENT][NEUTRAL] I'm here, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. I went ahead and send that over. It should be there in a few minutes.
[CUSTOMER][NEUTRAL] OK. Could you please tell me the card reference number for this?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information, Mr. [PII]?
[CUSTOMER][NEUTRAL] We don't have
[CUSTOMER][NEUTRAL] Uh, yeah, just give me a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Uh thank you for the information, sir. Have a nice day. Bye-bye.
[AGENT][POSITIVE] You as well. Thank you for calling ATM. bye bye.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Hm