AccountId: 011433970860
ContactId: 5f02da74-ec99-41aa-91f5-9b640aa61a76
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 841200 ms
Total Talk Time (AGENT): 179899 ms
Total Talk Time (CUSTOMER): 187449 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/5f02da74-ec99-41aa-91f5-9b640aa61a76_20250605T13:43_UTC.wav
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[AGENT][NEUTRAL] For calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, this is and I'm calling from office. May I know your name?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] How many?
[AGENT][NEUTRAL] Yeah, I, I can barely hear you.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Uh, now I'm on your.
[AGENT][NEUTRAL] Yeah, I can hear you now. I couldn't hear you before.
[CUSTOMER][NEUTRAL] OK, my name is [PII] and last question is [PII]. Can you please spell your name?
[AGENT][NEUTRAL] [PII], it's [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and your last insurance?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] D as in Delta.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And are, uh, what were you calling for claim status?
[CUSTOMER][NEUTRAL] Uh, I
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hey, do you have a good callback number?
[CUSTOMER][NEUTRAL] The callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] You have the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh, yeah, the policy number is D as in Delta 43730559.
[AGENT][NEUTRAL] Um, that policy number is for 90 Degree benefits, which I can transfer you over to, but we also have policies for those patients. Do you have the last name of the patient?
[CUSTOMER][NEUTRAL] OK. Patient last name is [PII] and first name is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] No, it's [PII].
[AGENT][NEUTRAL] And the first name?
[CUSTOMER][NEUTRAL] First name is [PII].
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And you have the date of birth?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] The date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] The date of service and bill charges?
[CUSTOMER][NEUTRAL] Date of is [PII] and the charge amount is $275.02.
[AGENT][NEUTRAL] OK, it looks like we received the claim on 11-25 24, processed 11-2724.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEGATIVE] It was denied because coverage terminated 526-24.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, what was the date? 52?
[AGENT][NEUTRAL] 526, 24.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] And uh has some updated the CB.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] As member of the COB coordination of benefits.
[AGENT][NEUTRAL] Um, I don't show anything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you please check if the last updates you be there.
[AGENT][NEUTRAL] Uh, we don't have anything on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have a next number.
[CUSTOMER][NEUTRAL] And the member is same but data service is different.
[AGENT][NEUTRAL] The data service?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] I'm sorry, what was the date? I can still barely hear you, so.
[CUSTOMER][NEUTRAL] OK, uh, the date of service is [PII].
[AGENT][NEUTRAL] Uh, that claim was received, uh, let's see.
[AGENT][NEGATIVE] Uh, received 33125 processed 4-3-2025, and it's denied there, it's after the termination date of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I have my next claim.
[CUSTOMER][NEUTRAL] Uh, it is the same patient. What date of service is different.
[AGENT][NEUTRAL] And what date of service?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEGATIVE] Claim received 1113-2024, processed 11-142024, denied.
[AGENT][NEUTRAL] Termination date [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I have a uh last name for different patient.
[AGENT][NEUTRAL] You have another claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The day service.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] For different patients.
[AGENT][NEUTRAL] Oh, for a totally different patient?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The policy number?
[CUSTOMER][NEUTRAL] It's 02486376.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] D of service and bill charges?
[CUSTOMER][NEUTRAL] Data service is [PII] and charge amount is $467.
[AGENT][NEUTRAL] And who is the provider on it? Or do you have one of the codes?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Um, we build a few CPT codes. First one is 992-049-900830363641536416.
[CUSTOMER][NEUTRAL] And last one is [PII].
[AGENT][NEUTRAL] And that was [PII], correct?
[CUSTOMER][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, looks like let's see, um, 3491 OK.
[AGENT][NEUTRAL] Uh, that one was received on [PII], processed [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We made a payment of 225.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Check number, single check, 201.
[AGENT][NEUTRAL] 5540.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It is a check number, right?
[AGENT][NEUTRAL] Yeah, 2,015,540.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] What is the paid amount?
[AGENT][NEUTRAL] 225
[CUSTOMER][NEGATIVE] No, they don't pay the amount.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Paid the amount.
[AGENT][NEUTRAL] 225.
[CUSTOMER][NEUTRAL] It is a paid amount 225.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, hasn't the payment cleared or not?
[AGENT][NEUTRAL] Uh, let's see
[AGENT][NEUTRAL] OK, I'm sorry, the paid amount was 119, sorry.
[CUSTOMER][NEUTRAL] OK, 119.
[AGENT][NEUTRAL] Yes, the, the payment cleared on [PII]. Do you need the address?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What was the date for?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] OK.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] And your address?
[AGENT][NEUTRAL] The address
[CUSTOMER][NEUTRAL] And address.
[AGENT][NEUTRAL] Address we sent it to [PII].
[CUSTOMER][NEGATIVE] Mmh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Can you please repeat that uh zip code [PII] something.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And next,
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I know the reference number?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Reference number?
[AGENT][NEUTRAL] Reference number is my name and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much bye bye.
[AGENT][POSITIVE] Thank you for calling APL. Bye-bye.