AccountId: 011433970860
ContactId: 5bbd4548-6a0f-4348-a22a-0ff81d36f978
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 214949 ms
Total Talk Time (AGENT): 107670 ms
Total Talk Time (CUSTOMER): 59760 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/5bbd4548-6a0f-4348-a22a-0ff81d36f978_20250224T16:25_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello [PII] how are you?
[AGENT][POSITIVE] I'm doing well, thank you for asking. How are you today?
[CUSTOMER][POSITIVE] I'm pretty good. I am calling checking claim status on a patient.
[AGENT][POSITIVE] It found pleasure to help you with that claim status. What is your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for selling. What is the callback number?
[CUSTOMER][NEUTRAL] My direct line is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. What is the patient's policy number, please, ma'am?
[CUSTOMER][NEUTRAL] 0246
[CUSTOMER][NEUTRAL] 2932.
[AGENT][NEUTRAL] And the patient's name and date of birth, please, ma'am.
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Alright, thank you, and it would be my pleasure to assist you with that claim status for [PII]. What is, excuse me, what is the data service?
[CUSTOMER][NEUTRAL] Data service is 12-10-2024.
[AGENT][POSITIVE] Thank you. And for the step bill amount?
[CUSTOMER][NEUTRAL] Total bill amount $165.
[AGENT][NEUTRAL] And the facility name please ma'am.
[CUSTOMER][NEUTRAL] Lexington Medical.
[AGENT][POSITIVE] Thank you. Is that um podiatry?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And [PII], I'm showing that we did receive that claim on [PII] and it was processed on [PII]. The claim was denied as office visits are not covered, and that is per the policy guidelines.
[AGENT][NEUTRAL] Would you like that claim number?
[CUSTOMER][NEUTRAL] Uh yes, ma'am.
[AGENT][NEUTRAL] The claim number is 355.
[AGENT][NEUTRAL] 8027.
[CUSTOMER][NEUTRAL] Alright, and I have another data service for the same patient.
[AGENT][NEUTRAL] Alright, and that data service.
[CUSTOMER][NEUTRAL] That data service is 1226-24.
[CUSTOMER][NEUTRAL] For 70 $75.
[AGENT][NEUTRAL] And that.
[AGENT][NEUTRAL] Is it for the same facility?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And you said the total bill amount is 75?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] So I have a claim for that data service for Lexy podiatry for the CPT 99214.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But it's a different build amount.
[CUSTOMER][NEUTRAL] 240.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] OK, that claim we received on [PII] and processed on [PII] and denied for the same reason. Office visits are not covered.
[CUSTOMER][NEUTRAL] Alrighty, can I get that claim number?
[AGENT][NEUTRAL] The claim number is 3559055.
[CUSTOMER][NEUTRAL] And a reference number.
[AGENT][NEUTRAL] Reference number is my name and today's date.
[AGENT][NEUTRAL] You need me to spell my name?
[CUSTOMER][POSITIVE] Oh no ma'am, I haven't. I do thank you though.
[AGENT][POSITIVE] It's my pleasure to assist you with that claim status, Priscilla. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No ma'am, I do thank you.
[AGENT][POSITIVE] And thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] And same to you bye bye.
[AGENT][POSITIVE] Thank you, bye bye.