AccountId: 011433970860
ContactId: 5a525b33-87b9-48f4-9396-e42fda23415a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2105600 ms
Total Talk Time (AGENT): 544187 ms
Total Talk Time (CUSTOMER): 692517 ms
Interruptions: 18
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/5a525b33-87b9-48f4-9396-e42fda23415a_20250212T20:52_UTC.wav
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[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, I'm [PII] calling from provider's office regarding calling student.
[AGENT][NEUTRAL] Hi [PII], um, can I please get your callback number and I can help you with your claim status.
[CUSTOMER][NEUTRAL] And the call back number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you. And what's the patient's name?
[CUSTOMER][NEUTRAL] Pa's first name is going to be uh.
[CUSTOMER][NEUTRAL] [PII] and the last name is uh so the [PII].
[AGENT][NEUTRAL] OK, and what's um [PII]'s date of birth?
[CUSTOMER][NEUTRAL] So date of birth is uh [PII].
[AGENT][POSITIVE] Thank you and the policy number please?
[CUSTOMER][NEUTRAL] Policy number is 01941775 M as in Mike L as in Lima H.
[AGENT][POSITIVE] Thank you, let me look up that policy real quick.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and then what is the date of service for [PII]?
[CUSTOMER][NEUTRAL] The date of service is uh
[CUSTOMER][NEUTRAL] [PII] with the bill amount of
[CUSTOMER][NEUTRAL] 2600.
[CUSTOMER][NEUTRAL] $24 even.
[AGENT][NEUTRAL] Thank you. And then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Actually, uh, after the primary paid, the charge amount needs to be paid by secondary is 571 dollars.50 cents.
[CUSTOMER][NEUTRAL] Was that
[AGENT][NEUTRAL] Thank you and what's the name of the facility sir that you're calling from?
[CUSTOMER][NEUTRAL] I'm calling from uh.
[CUSTOMER][NEUTRAL] Gastro Health LLC.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, [PII]. I'm gonna look up this claim for you and I'll be right back.
[CUSTOMER][NEUTRAL] Sure, please.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] I don't.
[AGENT][NEUTRAL] Hi [PII], this is [PII] back with you again. So looking on data service of [PII], I do not find a claim on file for the amount that you have given me.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Actually, uh, like I do have previously one of my representative follow up the claim and I do have the received any loan like I do have a claim number. I'm sorry.
[AGENT][POSITIVE] Yes, please give that to me.
[CUSTOMER][NEUTRAL] The claim number is 33709.
[CUSTOMER][NEUTRAL] 59.
[AGENT][NEUTRAL] 337-095-9, is that correct?
[CUSTOMER][NEUTRAL] Yes sir, right.
[AGENT][NEUTRAL] OK, let me look at that claim.
[CUSTOMER][NEUTRAL] Same.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, I do have the claim, but it was not for the same amount that you gave me. It wasn't for $2,634 or $71.50. Uh, the claim the claim.
[CUSTOMER][NEUTRAL] Yeah, actually, the charge amount is $26. Yeah, I'm sorry for disturbing in between. The charge, the claim bill amount is $2,624 even. 2624.
[AGENT][NEUTRAL] OK, that's
[AGENT][NEUTRAL] 262 4.
[AGENT][NEUTRAL] Let me look. 262 4.
[CUSTOMER][NEUTRAL] Yes, right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well.
[AGENT][NEUTRAL] OK, the claim that I have is for $571.50 and it was paid $571.50 and that's the claim number that you gave me.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. May I know what is the bill amount for this?
[AGENT][NEUTRAL] So the claim number that you gave me 337-095-9, the billed amount was $571.50.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] And the claim was paid $571.50 with check number 181.
[CUSTOMER][POSITIVE] I, it's too funny for the it's all that about that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 687.
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And let me look and see about that check.
[CUSTOMER][NEUTRAL] 15. It's 1816387. Am I right?
[AGENT][NEUTRAL] See if it's clear.
[AGENT][NEUTRAL] 18163887
[CUSTOMER][NEUTRAL] Sure, got it.
[AGENT][NEUTRAL] And that was for $531.50.
[AGENT][NEUTRAL] And I'm checking now to see if the check is cleared.
[AGENT][NEUTRAL] The check has cleared. It cleared on, it cleared on [PII].
[CUSTOMER][NEUTRAL] OK, I I I find that.
[CUSTOMER][NEUTRAL] When did
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] It's, I just can't.
[CUSTOMER][NEUTRAL] Like, upon checking, is it issued on [PII], am I right? because the process date is.
[AGENT][NEUTRAL] Let me look.
[CUSTOMER][NEUTRAL] [PII], right, can you please help me to clear that.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm sorry, what did you say help you with what sir?
[CUSTOMER][NEUTRAL] When did the check was cleared?
[AGENT][POSITIVE] It was cleared on.
[CUSTOMER][NEUTRAL] 615.
[CUSTOMER][NEUTRAL] 701
[AGENT][NEUTRAL] Let me look it up again.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] no.
[CUSTOMER][NEUTRAL] Uh, [PII], right? It was clear. OK, I just wanted to make sure. Can you please help me to verify the pay to address to which address it was the check was.
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] 3 years.
[AGENT][NEUTRAL] Yes, yes, it went to Gastro Health [PII] and it was a single check.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure, got it. OK. Shall we move to another claim [PII].
[CUSTOMER][NEUTRAL] It's for a different number?
[AGENT][NEUTRAL] OK let me put my note yes let me uh put you on hold, put my note in real quick and I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] OK, thank you. What is the next member's name?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The next number's name is uh [PII]. It's [PII], [PII], and the last name is [PII] and [PII]. Mhm.
[AGENT][NEUTRAL] Thank you. And then what's [PII]'s date of bir[PII]?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and [PII]'s policy number?
[CUSTOMER][NEUTRAL] Policy number is uh
[CUSTOMER][NEUTRAL] 1941602.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK and then what is um the data service for [PII]?
[CUSTOMER][NEUTRAL] Like.
[CUSTOMER][NEUTRAL] Data service is [PII] with the bill amount of.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $3,045 even.
[AGENT][NEUTRAL] OK, and then what is the build the the primary paid their part?
[CUSTOMER][NEUTRAL] After primary paid that part.
[CUSTOMER][NEUTRAL] The patient responsibility is for $21. 60 cents.
[AGENT][NEGATIVE] OK, can you repeat that again because the phone made a glitch while you were saying it.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, it's $421. 60 cents.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, thank you. And then it's also for gastrohealth?
[CUSTOMER][NEUTRAL] Just give me one second.
[CUSTOMER][NEUTRAL] No, it's for different tax ID.
[AGENT][NEUTRAL] OK, who is it for?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] The tax ID is 272862.
[CUSTOMER][NEUTRAL] 377
[AGENT][NEUTRAL] That's OK. I'll need the name of the facility.
[AGENT][NEUTRAL] Please.
[CUSTOMER][NEUTRAL] Galloway Anesthesia Associates.
[AGENT][NEUTRAL] Galloway.
[AGENT][NEUTRAL] Anesthesia. OK, I'm gonna put you on hold again. I'll be right back.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sure. You are on hold.
[AGENT][NEUTRAL] $3,045.
[AGENT][NEUTRAL] 342-926-4.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hi, [PII], this is [PII]. So I do have um the claim for you. It is uh the number is 342-926-4.
[CUSTOMER][NEUTRAL] Yeah, hello.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] But I guess that.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] And the claim was denied and this is the remark, the maximum amount payable for this occurrence has been met. Per occurrence means treatment for the same or related condition unless separated by a period of 90 days.
[CUSTOMER][NEUTRAL] It didn't
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Sure, [PII], I do understand you're saying that the claim was got denied.
[AGENT][NEUTRAL] So treatment for the same.
[CUSTOMER][NEUTRAL] And shedding maximum benefits exhaustion, right?
[AGENT][NEUTRAL] Right, because the, um,
[AGENT][NEGATIVE] The treatment didn't have, it needs to be 90 days in between treatments. So this was not 90 days, so it was denied.
[CUSTOMER][NEUTRAL] And you just find your.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] So, like, upon checking, like, uh, uh, I just want to, you're stating that the maximum benefits have been adjusted. I just wanted to know whether it was in uh as per visits or as per dollar amount.
[AGENT][NEUTRAL] The whole claim was denied per the patient's policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Patient's policy.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] Not for maximum benefits exhaustion.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yeah, it maxed out its benefit for that occurrence was met.
[CUSTOMER][NEUTRAL] OK, I just wanted to know, uh, like, uh, what is the dollar amount as per calendar year?
[CUSTOMER][NEUTRAL] Starting from [PII].
[AGENT][NEUTRAL] It's not a dollar amount.
[AGENT][NEUTRAL] The
[CUSTOMER][NEUTRAL] Did you send them that
[AGENT][NEUTRAL] What the treatment was, what the procedure was, can only be done every 90 days.
[CUSTOMER][NEUTRAL] OK, uh stating, uh, OK, uh, previously under which claim, uh.
[CUSTOMER][NEUTRAL] The the procedure call was done.
[CUSTOMER][NEUTRAL] Before completing the 90 days.
[AGENT][NEGATIVE] I'm not gonna, I'm not gonna give you that because that's private information.
[AGENT][NEUTRAL] It could be somebody besides your facility.
[CUSTOMER][NEUTRAL] OK, I sharing that the the claim was denied for the maximum maximum benefits exhaustion as for the CPT 00811 because it was, uh, need to be billed after the 90 days. Am I right?
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Yes, correct, yes, you are very correct.
[CUSTOMER][NEUTRAL] I just wanted to know like.
[CUSTOMER][NEUTRAL] I just wanted to confirm for which date of service is possible. I just need the date of service. I don't need any information.
[AGENT][NEUTRAL] Uh, I can't, I can't give you that.
[CUSTOMER][NEUTRAL] But which
[AGENT][NEUTRAL] Uh, that's telling you what day that the patient went to the doctor and that's private information.
[CUSTOMER][NEUTRAL] Sure, can you send me a copy of your fax? You mail us uh to the provider, sir?
[AGENT][POSITIVE] Yeah, absolutely. Can I get your fax number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], hold on just real quick and I'm gonna get that over to you, OK?
[CUSTOMER][NEUTRAL] Yes. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Come on, Prince.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi, [PII]. This is [PII] and I'm back with you again.
[CUSTOMER][POSITIVE] Yeah, this is the correct billing.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] I've got that fax on the way for you for the EOB.
[CUSTOMER][NEUTRAL] Sure. OK, you move to another claim which a different number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know, like, uh, you have, you have been, yeah, OK, got it.
[AGENT][NEUTRAL] OK, and what is the next member's name?
[CUSTOMER][NEUTRAL] They from one job.
[CUSTOMER][NEUTRAL] Sure, uh.
[CUSTOMER][NEUTRAL] The next member's name was just give me a second. I'll help you that.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah, I just came a second please on mine. My body just loading.
[AGENT][NEUTRAL] Yes, sir, go ahead.
[AGENT][POSITIVE] Yes, take your time.
[CUSTOMER][NEUTRAL] Sure thank you. Please, what's the name and just with the offices.
[CUSTOMER][POSITIVE] Hello. Yeah, just give me a second, please. Thanks for that information.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah, the next member's name is [PII]. Let me ask you, yes, [PII]
[AGENT][NEUTRAL] OK, and what's um [PII]'s last name?
[AGENT][NEUTRAL] OK, and then his date of birth?
[CUSTOMER][NEUTRAL] Date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and his policy number?
[CUSTOMER][NEUTRAL] 01896036 M as in Mike L as in Lima H.
[AGENT][NEUTRAL] OK, and then what is the data service for him?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The date of service for him is uh [PII].
[AGENT][NEUTRAL] OK, and then what's his charge amount?
[CUSTOMER][NEUTRAL] The bill amount is $2610 even.
[AGENT][NEUTRAL] And the
[AGENT][NEUTRAL] Charges after primary paid their part?
[CUSTOMER][NEUTRAL] It's $285.
[AGENT][NEUTRAL] OK, thank you. And then what is the name of the facility?
[CUSTOMER][NEUTRAL] The name of the facility is Galloway Anesthesia Associates.
[AGENT][NEUTRAL] Galloway. OK. All right. I will put you on hold again. I'll be right back, [PII].
[CUSTOMER][NEUTRAL] That's.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi, [PII], this is [PII] back with you.
[AGENT][NEUTRAL] So I do have the claim number is 3506454. The claim was denied because the outpatient benefit maxed out for the year.
[AGENT][NEUTRAL] You there?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah, hello, uh, hello, hello. I'm sorry. Uh, yeah, hello. I'm sorry. Actually, you're shedding in the for this claim this, uh, the maximum benefits are exhausted for this claim as well, right?
[AGENT][NEUTRAL] Hello. Oh hi, that's OK.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Repeat one more time.
[AGENT][NEUTRAL] Yes, for the calendar year, yes.
[CUSTOMER][NEUTRAL] I spend the calendar year. OK. May I know when did the claim was received to you?
[AGENT][POSITIVE] Yes sir, let me look that up for you real quick.
[CUSTOMER][NEUTRAL] And when the claim was issued and when the claim was not denied. Can you please help me with that?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, I can look that up for you. The claim was received on [PII].
[AGENT][NEUTRAL] And the claim was processed on [PII].
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] [PII], right? OK, you're setting, uh, the maximum, the, just give me a second. I'm adding a short note, don't mind.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] May I know how many like uh per year how many, uh times we can rebuild build up service code.
[CUSTOMER][NEUTRAL] For this claim.
[CUSTOMER][NEUTRAL] For this number I'm sorry.
[AGENT][NEUTRAL] Well, the, well, the claim was denied because the um outpatient benefit maximum for the year was exhausted.
[CUSTOMER][NEUTRAL] Yeah, it'll be at the.
[AGENT][NEGATIVE] So they ran out of money for the year for their claim.
[AGENT][NEGATIVE] It was exhausted so if you send it in, it's gonna be denied again because the benefit was maxed out for the calendar year.
[CUSTOMER][NEUTRAL] Yeah, I do understand. OK, it's maximum digits are exhaustion as per year, right.
[AGENT][NEUTRAL] Yes, for the calendar year.
[CUSTOMER][NEUTRAL] May I know how many digits are there as per calendar year? How many benefits are there like?
[AGENT][NEUTRAL] OK, what's what's the dollar amount for the calendar year for outpatient is $500.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] And that $500 was used up.
[CUSTOMER][NEUTRAL] No, I just wanted to know.
[CUSTOMER][NEUTRAL] Like you have been shared that maximum benefits are exhausted as per year, right?
[CUSTOMER][NEUTRAL] What are the maximum weight for like just as per visits or as per dollar amount?
[AGENT][NEUTRAL] The
[CUSTOMER][NEUTRAL] So that's uh I'm asking a specific question.
[AGENT][NEUTRAL] OK, so this, right, I understand what you're saying this policy only pays for deductible, co-pay, and coinsurance. So this is just to verify his benefits. It's not a guarantee of payment. His outpatient calendar year benefit for the year is $500. That $500 was used up.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And that's why the claim was denied.
[CUSTOMER][NEUTRAL] OK. As per dollar amount and the maximum benefits have been exhausted and you are setting as per year only 500 $500 maximum dollars are used, I'm right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, uh, can you please help me in providing under, under, yeah, under which claim, uh, it was the magma Medford suggested.
[AGENT][NEUTRAL] Right, $500 calendar year.
[AGENT][NEUTRAL] No, I can't give you that information. That's the same situation as before. I can't tell you who maxed it out and when they went to the doctor and who it was and where it was and what date it was. I can't tell you that.
[CUSTOMER][NEUTRAL] OK, do you have any, OK, I don't be able to provide because it's built on a different provider.
[AGENT][NEUTRAL] It could be, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, got it. Uh, can you send me a copy of your with the facts for this claim as well.
[AGENT][NEUTRAL] Yes, sir, to the same fax number?
[CUSTOMER][POSITIVE] Yes, you're right.
[AGENT][NEUTRAL] OK, hold on for just a second, let me get that to you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK [PII], I've got that fax on its way to you.
[CUSTOMER][NEUTRAL] Sure. OK. Uh, the claim number is 3506454. Am I right?
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Sure, got it. Uh.
[CUSTOMER][NEUTRAL] Yeah, shall we move to another claim this is the last claim I do have for mine.
[AGENT][NEUTRAL] OK. All right. What's the um member's name?
[CUSTOMER][NEUTRAL] My first name is uh [PII]
[CUSTOMER][NEUTRAL] My my first name and the last name is uh
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, no, no. I'm sorry, I'm sorry. It's not an, it's a different name. I'm really sorry. It's my mistake.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, what's the member's name?
[CUSTOMER][NEUTRAL] Yeah, my first name is going to be [PII] Mm no. Thische please.
[AGENT][POSITIVE] Yes, sir. Take your time.
[CUSTOMER][NEUTRAL] Yeah, my first name is [PII]. It's [PII].
[CUSTOMER][NEUTRAL] But I need to ask if I don't think that.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then what's [PII]'s last name?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] OK, and then what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Date of birth is uh.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And then what is the policy number, please?
[CUSTOMER][NEUTRAL] The policy number is
[CUSTOMER][NEUTRAL] 02509.
[CUSTOMER][NEUTRAL] 520 M as in Mike L as in Lima number 8.
[AGENT][NEUTRAL] OK, let me look that one up for us.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] OK, and what is the date of service?
[CUSTOMER][NEUTRAL] of services [PII].
[CUSTOMER][NEUTRAL] $542 you want.
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, and then what is the charge after primary paid their part?
[CUSTOMER][NEUTRAL] $80 for them.
[AGENT][NEUTRAL] OK and the name of the facility?
[CUSTOMER][NEUTRAL] The name of the facility is uh Gastro.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Gastrohealth.
[CUSTOMER][NEUTRAL] That gastro.
[AGENT][NEUTRAL] OK. All right, [PII], I'm gonna put you on hold again. I'm gonna look up this one for you. I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], I have the claim for you.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The claim number is 354.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] 1203.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the claim was denied because office visits are not covered for the patient's policy.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Sure, got it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, what does the mobile plan have?
[CUSTOMER][NEUTRAL] so you can.
[AGENT][NEUTRAL] The name of the plan is Medlink.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Got it. OK. That's all the information, right? Thank you. Can you please help me the call reference, please?
[AGENT][NEUTRAL] Yes sir, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] That's all the information. Thank you for assistance. Have a wonderful day.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You too, [PII]. Thank you so much. You have a blessed day and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] But it's a lot.