AccountId: 011433970860
ContactId: 5af3a2a0-a1b9-4570-99d9-1596b8dcdb57
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 499320 ms
Total Talk Time (AGENT): 109340 ms
Total Talk Time (CUSTOMER): 106383 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/5af3a2a0-a1b9-4570-99d9-1596b8dcdb57_20250610T16:33_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh definitely, this is calling from provider's office to check on a claim.
[AGENT][NEUTRAL] OK. I, I missed your name. What was that?
[CUSTOMER][NEUTRAL] He
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and do you have the policy number for claim status?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's gonna be 002.
[CUSTOMER][NEUTRAL] 320
[CUSTOMER][NEUTRAL] 063.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Right, it's for [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Day of service and bill charges.
[CUSTOMER][NEUTRAL] It's for [PII] for an amount of $408 even.
[AGENT][NEUTRAL] Uh, it was received 11-13-2024.
[AGENT][NEUTRAL] Process [PII]:15 2024.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] So the patient is responsible for this, right?
[AGENT][NEUTRAL] Uh, we can't determine patient responsibility as a secondary policy.
[CUSTOMER][POSITIVE] OK, I got you.
[CUSTOMER][NEUTRAL] I do have 2 more data services for the same number. Could you please help me with them?
[AGENT][NEUTRAL] Uh, sure. What's the date of service?
[CUSTOMER][NEUTRAL] The next one is for [PII]. And the other one.
[CUSTOMER][NEUTRAL] Whenever you're ready.
[AGENT][NEUTRAL] What is the bill charges?
[CUSTOMER][NEUTRAL] Uh, for this 1 $412 even?
[AGENT][NEUTRAL] Uh, that claim was received 11-13-2024. Proceed 11-15 2024.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You need a copy of the primary explanation of benefits.
[CUSTOMER][NEUTRAL] She
[CUSTOMER][NEUTRAL] You needed the copy of primary explanation of benefits?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] May I know the primary insurance details for this one?
[AGENT][NEUTRAL] United Healthcare.
[CUSTOMER][POSITIVE] That's cool.
[CUSTOMER][NEUTRAL] Could you please help me the claim number for this one?
[AGENT][NEUTRAL] 353-808223530822.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] 353-082-2, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, could you please help with the claim now for [PII]? Sorry, I missed that.
[AGENT][NEUTRAL] Oh, that one was.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] 353-082-7
[CUSTOMER][NEUTRAL] Yeah. When are you ready for the last one? It's for [PII].
[CUSTOMER][NEUTRAL] For an amount of 117.
[AGENT][NEUTRAL] Uh, that was received 11-13-2024, processed 11-15, 2024.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Uh, we need a copy of the primary explanation of benefits. Claim number is 353-0825.
[CUSTOMER][NEUTRAL] 08
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And I do have the last.
[CUSTOMER][NEUTRAL] claim which is for a different number and different data service.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] 990178.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] It's for [PII] on the date of [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] It's for [PII] for an amount of $257 even.
[AGENT][NEUTRAL] OK, sorry, I didn't catch the first part. What was the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And for 257?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, received on [PII]. Proceed [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Calendar year maximum dollar amount has been met for this benefit.
[CUSTOMER][NEUTRAL] OK. And may I know the maximum dollar amount for this one?
[CUSTOMER][NEUTRAL] And when was it last night?
[AGENT][NEUTRAL] Uh, like.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The dollar amount is $250. It was met 924, 24.
[CUSTOMER][NEUTRAL] [PII]:20 24.
[AGENT][NEUTRAL] 924, 24.
[CUSTOMER][NEUTRAL] But upon checking, so the data services for
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] And 6 right has been provided to the need of service.
[AGENT][NEUTRAL] Yeah, but we received it in November.
[CUSTOMER][POSITIVE] So I got you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No problem. Can you please help me the call reference number.
[AGENT][NEUTRAL] All references, my name is [PII], and today's date.
[CUSTOMER][POSITIVE] Thank you, thanks for the information. Have a nice day.
[AGENT][POSITIVE] Thanks for calling APL as well. Bye-bye.