AccountId: 011433970860
ContactId: 5bc54915-09aa-46a7-a161-9b66809b77ae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 682280 ms
Total Talk Time (AGENT): 117289 ms
Total Talk Time (CUSTOMER): 128582 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=-1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/5bc54915-09aa-46a7-a161-9b66809b77ae_20250130T21:47_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, good afternoon. My name is [PII], and last name is [PII]. I'm calling from provider's office regarding claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status um can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. [PII]. It is a direct line.
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name?
[CUSTOMER][NEUTRAL] OK. The patient name is [PII] and the date of birth is [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And what is [PII]'s policy number?
[CUSTOMER][NEUTRAL] 01665264 M for Mary, L for Lima, 8.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, and then what is the data service of the client?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, sure. It's 5:17-2024 and the total charge $2610 even.
[CUSTOMER][NEUTRAL] Ah
[AGENT][NEUTRAL] OK, and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Like how much primary pay you said right?
[AGENT][NEUTRAL] Yeah, the, what's the uh charge amount after the primary insurance paid their part.
[CUSTOMER][NEUTRAL] But they're not
[CUSTOMER][NEUTRAL] OK, after primary page, so and the remaining amount is 1 2nd.
[CUSTOMER][NEUTRAL] And the remaining amount is $370 is spending.
[AGENT][NEUTRAL] $378?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you, and then what is the name of the facility you're calling for [PII]?
[CUSTOMER][NEUTRAL] It's Galloway Anesthesia Associates.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I'll be right back.
[CUSTOMER][NEUTRAL] Yeah, sure, sure.
[AGENT][NEUTRAL] Sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK [PII] this is [PII] back with you again. I looked for the claim and I do not find a claim on file for the amount that you have given me.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK, like it's 2000, sorry, one second.
[CUSTOMER][NEUTRAL] $2610 that amount is not on file?
[AGENT][NEUTRAL] Right, it is not on file.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The service was 65 of 2024, is that correct?
[CUSTOMER][NEUTRAL] No, no. The date of service is [PII].
[AGENT][NEUTRAL] OK, let me go back on the policy and look again with that new data service. Hold on, please.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] That's weird.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Alright, thank you so much for holding for me, [PII]. I did find the claim. The claim number is 353-207-3.
[AGENT][NEUTRAL] The claim was denied because the benefit max for that date of service had been met.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, the claim number is 3,532,070, right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK. And thank you so much. So this claim was for the maximum benefits existed. Uh, it's $1 a month, or CPT.
[AGENT][NEUTRAL] It's dollar amount.
[CUSTOMER][NEUTRAL] OK. So is there any chance, can you please send any of through fax?
[AGENT][NEUTRAL] Yes sir, can I get fax number?
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[AGENT][NEUTRAL] Thank you, I'm gonna put you on hold while I get that faxed together for you and I'll be right back sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you [PII] for holding for me. I've got that fax on its way to you now.
[CUSTOMER][POSITIVE] Thank you so much and may I know the call reference number?
[AGENT][NEUTRAL] Yes sir, you can use my name. It's [PII] and today's date.
[CUSTOMER][POSITIVE] Yeah, thank you, [PII]. Thank you for giving this information. Have a nice day and happy weekend.
[AGENT][POSITIVE] Happy weekend to you too, [PII]. Thank you so much. Thanks for calling APL.
[AGENT][NEUTRAL] Bye-bye, sir.
[CUSTOMER][NEUTRAL] Yeah, same to you bye bye.