AccountId: 011433970860
ContactId: 58e204b2-0a4e-4088-a4db-7589d6e429da
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277140 ms
Total Talk Time (AGENT): 57376 ms
Total Talk Time (CUSTOMER): 87828 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/58e204b2-0a4e-4088-a4db-7589d6e429da_20250616T17:39_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling for the provider's office to check on additional information about the dinar claim and also this call is being recording for quality and training purpose.
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 915
[AGENT][NEUTRAL] OK. Do you have the patient ID?
[CUSTOMER][NEUTRAL] Uh, yeah, the patient ID number is going to be.
[CUSTOMER][NEUTRAL] OK, it is [PII].
[AGENT][NEUTRAL] OK, I'm sorry, could you repeat that again? Sorry about that.
[CUSTOMER][NEUTRAL] Uh, no problem. Uh, [PII].
[AGENT][NEUTRAL] And what was your name again? [PII]? I said.
[CUSTOMER][NEUTRAL] Uh [PII]
[AGENT][NEUTRAL] Do you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] OK. Callback number is gonna be [PII].
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] OK. Patient's name is uh [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] OK. The date of service is going to be [PII].
[CUSTOMER][NEUTRAL] And the bill amount is one moment uh.
[CUSTOMER][NEUTRAL] OK, bill amount it's going to be $467.52.
[AGENT][NEUTRAL] OK, and you had a question on the claim?
[CUSTOMER][NEUTRAL] Uh, yeah, this claim, uh, we received a payment for
[CUSTOMER][NEUTRAL] Uh, only one CPT code, uh, and the other code was denied. Can I get the denied reason?
[CUSTOMER][NEUTRAL] OK. 99213 was processed and paid.
[AGENT][NEUTRAL] Right, and the with the check, the maximum benefit payable for the date of service was met for the policy?
[CUSTOMER][NEUTRAL] OK. Uh, so two coats are denied for the same reason?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, one moment, uh.
[CUSTOMER][NEUTRAL] OK, maximum benefit exhausted, right? Is it by dollar value or visit, is it?
[AGENT][NEUTRAL] It's dollar amount, $75 is the max payable per day of service.
[CUSTOMER][POSITIVE] OK, per day. OK, thank you.
[CUSTOMER][NEUTRAL] OK, can I get the mailing address?
[AGENT][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] 11 [PII].
[CUSTOMER][NEUTRAL] I'm sorry, [PII]. What is the ZIP code?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, and the attention.
[AGENT][NEUTRAL] Appeals.
[CUSTOMER][NEUTRAL] Apples.
[CUSTOMER][NEUTRAL] Not calling limit.
[AGENT][NEUTRAL] 180 days from the date of service process.
[CUSTOMER][NEUTRAL] OK. And can I get your call reference number?
[AGENT][NEUTRAL] That's my name is [PII]. First last name [PII] and today's date.
[CUSTOMER][POSITIVE] OK, definitely. Thank you so much and thank you so much for today.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day. Bye-bye.