AccountId: 011433970860
ContactId: 5f3a0bc3-fb33-423a-b9c0-c8acffa7450a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2847939 ms
Total Talk Time (AGENT): 638977 ms
Total Talk Time (CUSTOMER): 525567 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/5f3a0bc3-fb33-423a-b9c0-c8acffa7450a_20250130T20:13_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. My name is [PII]. I'm calling from the provider's office to check on a claim status.
[AGENT][NEUTRAL] OK [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Uh no, I have like 8 of them with me.
[AGENT][NEUTRAL] You have 8 claims for 8 different patients?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, [PII], I can help you with that.
[AGENT][NEUTRAL] One moment, I'm gonna place you on a brief hold. You're welcome.
[CUSTOMER][POSITIVE] OK, thank you for that.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK [PII], thank you for holding for me. So what is a good call back number for you please?
[CUSTOMER][NEUTRAL] Yes, it would be [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you, and [PII], um, several things before we get started, you will use my name I gave you along with today's date if you need call reference numbers for the call today. Also, if we have the claims on file and on file and you need a copy of the explanation of benefits, you can go to our portal to print those out and that website for the portal is secured. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I understand.
[AGENT][NEUTRAL] And then lastly [PII], any information that I provide for you on any of the claims will be a verification of benefits and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So what is your first patient's policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, it's 10746207, Mike Lima number 8.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so something was off on that policy number that you just gave me. What is the number again?
[CUSTOMER][NEUTRAL] It's 01746207, Mike Lima and number 8.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes. First name is [PII], last name is [PII], and the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK, did you have something, ma'am?
[AGENT][NEUTRAL] And the, I haven't yet, no.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her please?
[CUSTOMER][NEUTRAL] Yes, it would be [PII] with the bill amount of $237 even.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] OK, so this claim was received, this claim was received on [PII]?
[AGENT][NEUTRAL] Processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 352-974-4.
[CUSTOMER][NEUTRAL] What.
[AGENT][NEUTRAL] And this claim was denied, office visits are not covered under this policy. The member's plan does not cover office visits.
[CUSTOMER][NEUTRAL] One.
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][NEUTRAL] OK, I understand.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][POSITIVE] OK, thank you for that. And ma'am, uh you did
[CUSTOMER][NEUTRAL] Uh, we need to get the you'll be from the.
[AGENT][NEUTRAL] [PII], are you still there? Oh, OK.
[CUSTOMER][NEUTRAL] Yes, I'm still there. You said that we need to get the EOB from the portal, but can you like fax us a copy of your?
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] Yes, sir, you can print all of these since you have 8 of them, you can print them from our portal.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, I'm just asking if you can like fax us a copy of this one.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Do you have access to the Internet, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's going to take a few minutes to load this information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK we're done.
[AGENT][NEUTRAL] And what is the fax number for me to send this to you once it loads?
[CUSTOMER][NEUTRAL] Yes, it would be
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm sorry, you
[AGENT][NEUTRAL] You only need to start every day and your voice went out. I didn't hear what you said.
[CUSTOMER][NEUTRAL] OK, I understand. It's 615.
[CUSTOMER][NEUTRAL] 7773536. And you can use my name as attention for that one, ma'am.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] yeah.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] you for
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I mean.
[AGENT][NEUTRAL] And again, that fax number is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Mm yes, ma'am.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] I look forward to it now.
[AGENT][NEUTRAL] OK, so that has been faxed to you. Do you need any other information on this claim, [PII]?
[CUSTOMER][NEUTRAL] Um, uh, no, ma'am. That would be it.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And your next patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it would be 01587412, Mike Lima number 7.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, first name is [PII]. Last name is [PII], and the date of birth would be on [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Data service and total build amount please.
[CUSTOMER][NEUTRAL] Yes, data services on [PII] with the bill amount of $358 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, this claim was also received. This claim was received on [PII], processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 3532548.
[AGENT][NEUTRAL] And the reason for the denial on this claim states these services were rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] OK, so.
[AGENT][NEUTRAL] She did not have an active policy with APO for this service date.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK, I understand, ma'am. Could you provide me with the effective and termination dates for this patient?
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, the effective date on this plan had been [PII].
[AGENT][NEUTRAL] And the termination date on this policy was [PII].
[CUSTOMER][NEUTRAL] [PII]. I understand. Thank you for that information, ma'am. And for this one also, could you like fax us a copy of UV?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Are you going to need me to fax all 8 of these instead of printing them yourself?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Oh yes, because we prioritize faxes more than that.
[AGENT][NEUTRAL] I'm sorry, say that again.
[CUSTOMER][NEUTRAL] Uh, because we prioritize facts over printing it ourselves because it, uh, provided us.
[AGENT][NEUTRAL] I'm sorry. uh uh OK, I didn't understand that. Just a moment.
[CUSTOMER][NEUTRAL] Hello, ma'am?
[AGENT][POSITIVE] I am still here. Yes, I am. I'm working on getting your facts sent to you.
[CUSTOMER][NEUTRAL] Uh, still there?
[CUSTOMER][POSITIVE] OK. Thank you for that, ma'am.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That one has been sent.
[AGENT][NEUTRAL] And the other one does show as received.
[CUSTOMER][POSITIVE] Uh yes, we just received that. Thank you for that, ma'am.
[AGENT][NEUTRAL] You're welcome. What is the next patient's policy number?
[CUSTOMER][NEUTRAL] OK. The next patient's policy number. Give me a second.
[CUSTOMER][NEUTRAL] OK. It's 10650682, Mike Lima number 8.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEGATIVE] OK, so that number is not correct. Give me that number again. What you gave me 10650682, that is not correct. That's not a valid number.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, let me provide it once more. It's 1, OK. It's 01650682 Mike Lima number 8.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes. Patient's first name is [PII]. Last name is [PII], and the date of birth is on [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Data service and total bill amount?
[CUSTOMER][NEUTRAL] Yes, data service is on [PII] with a bill amount of $1500 even.
[AGENT][NEUTRAL] OK, so this claim has been received multiple times. The most recent one was denied as a duplicate. Do you need the other claims information?
[CUSTOMER][NEUTRAL] Uh yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's received 8-7-2024 and processed on 8-13-2024.
[AGENT][NEUTRAL] The claim number is 3492143.
[AGENT][NEUTRAL] And it was denied stating the outpatient benefit for this calendar year has been met.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] And ma'am, could you provide me with the last time this patient has reached his benefits in this year?
[AGENT][NEUTRAL] That same data service.
[AGENT][NEUTRAL] On a different claim.
[CUSTOMER][NEUTRAL] OK, I understand.
[CUSTOMER][NEUTRAL] Could you provide me with a claim number for that one?
[AGENT][NEUTRAL] No, sir, I can't provide another provider's client's information to you.
[AGENT][NEUTRAL] I can only provide the information related to the claim that was filed on behalf of your provider.
[CUSTOMER][NEUTRAL] Oh, I understand, ma'am.
[CUSTOMER][NEUTRAL] OK, I understand. Thank you for that information, ma'am. And for this one also, we do need to receive, do, can we like receive a fax for this one too?
[AGENT][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] It's still loading.
[AGENT][NEUTRAL] It's still loading, [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am. I understand.
[AGENT][NEUTRAL] OK, and that one has been faxed. Is there any other information you need on this policy?
[CUSTOMER][NEUTRAL] Um, ma'am, could you like provide me with the claim number once more for this one?
[AGENT][NEUTRAL] 349-2143
[CUSTOMER][NEUTRAL] 2143. Thank you for that, yes. And that would be for this one, ma'am. Should I go ahead and provide you with the next member's ID?
[AGENT][NEUTRAL] No, not yet, just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I'm starting to get error messages stating that your fax number is busy.
[AGENT][NEUTRAL] So it will only make a certain number of attempts [PII] before it will time out.
[AGENT][NEUTRAL] So if your fax line is busy after so many tips it will stop trying to fax it so in that case you would need to print it from the portal.
[CUSTOMER][NEUTRAL] OK, and
[CUSTOMER][POSITIVE] Yes, ma'am. I understand. Thank you for that information. No problem with that.
[AGENT][NEUTRAL] You're welcome. And what is the next policy number?
[CUSTOMER][NEUTRAL] Yes, it would be 130.
[CUSTOMER][NEUTRAL] 976
[CUSTOMER][NEUTRAL] 3 Mike Lima 7.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Because it's what somebody said like message.
[AGENT][NEUTRAL] OK. And any inform OK. And what is your patient's name? I'm sorry, and date of birth on this one?
[CUSTOMER][NEUTRAL] Yes, the patient's first name is [PII]. Last name is [PII], and the date of birth is on [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount please.
[CUSTOMER][NEUTRAL] Yes, the date of service is on [PII].
[CUSTOMER][NEUTRAL] With the bill amount of $348 even.
[AGENT][NEUTRAL] 340.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Uh, ma'am, it's not 3:40, it's 3:48, 348.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, for 7:30 2024. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so there is no claim on file for this data service?
[AGENT][NEUTRAL] And this policy was not active for that data service.
[CUSTOMER][NEUTRAL] Uh, is that so? Could you provide me with the effective and termination date for this one, ma'am?
[AGENT][NEUTRAL] This policy was active from [PII].
[AGENT][NEUTRAL] There is another policy number for this number that is active under a different policy number.
[AGENT][NEUTRAL] Let me see. The the current active policy is 02255706 effective [PII] and the termination date it is still active. So give me just a moment to see if it was received and processed under the correct number.
[CUSTOMER][NEUTRAL] Uh, could you provide me with that one, ma'am?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, I understand, ma'am.
[AGENT][NEUTRAL] And this claim was received and processed under the correct policy number and it was received on [PII] and processed the same date.
[AGENT][NEGATIVE] It was denied.
[AGENT][NEUTRAL] The claim number is 3531438.
[AGENT][NEUTRAL] And the reason for the denial on this claim is also office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Mm, let's see. OK, thank you for that, ma'am. Let me go ahead and provide you with the next member's ID.
[AGENT][NEUTRAL] and you don't need this one faxed? You don't need the COB?
[CUSTOMER][POSITIVE] Uh, no problem.
[CUSTOMER][POSITIVE] Uh, no problem, ma'am. We'll get it through that.
[CUSTOMER][NEUTRAL] Uh, the portal.
[AGENT][NEUTRAL] You're OK. Well, then let me make my note if you don't.
[AGENT][NEUTRAL] Just a moment.
[CUSTOMER][POSITIVE] OK. Thank you, ma'am.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] So you do not want me to fax you this EOB?
[CUSTOMER][NEUTRAL] Um, well, you did say this, uh, that the fax number was busy, but if you can please try once.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I don't think you're something.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] So we have submitted.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, and that one has been sent to you. What is the next patient's policy number?
[CUSTOMER][NEUTRAL] Yes, ma'am. The next policy number is 02501707.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, ma'am. The patient's first name, once again, ma'am, my system hang up.
[AGENT][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] Oh yes, the patient's first name is [PII]. Last name is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] Yes, the date of birth is on [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so the one that the, I just received a notification on the Mr. [PII]'s, it's, I'm getting a busy uh I just got an error message stating the line was busy. Again, it may still go through, but it hasn't as of yet.
[AGENT][NEUTRAL] And what is the date of service for Miss you and her total bill amount?
[CUSTOMER][NEUTRAL] And assign, ma'am.
[CUSTOMER][NEUTRAL] Yes, it's on [PII] with the bill amount of $348 even.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] OK, so this claim was also received. It was received on 12-11-2024, processed on 12-13-2024.
[AGENT][NEUTRAL] The claim number on this one?
[AGENT][NEUTRAL] It's 354.
[AGENT][NEUTRAL] 1132.
[AGENT][NEUTRAL] This claim was also denied, as office visits are not covered.
[CUSTOMER][NEUTRAL] Yeah, I understand, ma'am. Thank you for that information. And for this one also, could you like fax us a UOB?
[AGENT][NEUTRAL] Mhm. And just one moment.
[AGENT][NEUTRAL] Yes, it's yeah I'm trying to load the information now.
[CUSTOMER][POSITIVE] Yes, thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We
[AGENT][NEUTRAL] OK, so this one has also been sent. Is there anything else that you need on this policy?
[CUSTOMER][NEUTRAL] Uh no, ma'am.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, the next member's policy number?
[CUSTOMER][NEUTRAL] Yes, it's 02509857.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] And your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and the date of birth is on [PII].
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the date of service and total bill amount?
[CUSTOMER][NEUTRAL] Yes, it's [PII] with the bill amount of $2,467 even.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] This claim was received on [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[AGENT][NEUTRAL] The claim number is going to be 3544734.
[AGENT][NEUTRAL] This claim was also denied?
[AGENT][NEUTRAL] And the reason for the denial, I'm going to fax the EOB, but I will read the remark. We have received the primary explanation of benefits that was submitted with your claim. However, the explanation of benefits received does not list the amounts applied to the deductible, co-pay, or co-insurance. Please submit a more detailed explanation of benefits that shows these amounts for further consideration of the claim.
[CUSTOMER][NEUTRAL] I understand, ma'am. So if we have the explanation of benefits, can we like refile the claim for this one?
[AGENT][NEUTRAL] You would just need to send us a detailed explanation of benefits, not the entire claim, we're only needing a detailed explanation of benefits.
[CUSTOMER][NEUTRAL] OK, I understand, ma'am.
[CUSTOMER][NEUTRAL] Uh, could you provide me with the fax number to submit this explanation of benefits to?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Yeah, thank you for that, ma'am. And is there any timely filing for this?
[AGENT][NEGATIVE] There is not.
[CUSTOMER][NEUTRAL] Yeah, I understand.
[CUSTOMER][POSITIVE] You and yes that would be it for this one also, ma'am.
[AGENT][NEUTRAL] So do you need this one faxed with these remarks on it?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so just a moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] It takes a moment to load the explanation of benefits in order for me to be able to fax them to you.
[CUSTOMER][POSITIVE] Thanks for that, ma'am. Thanks for uh taking that much time of your time.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] On
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah so they.
[AGENT][NEUTRAL] So that one has also been faxed, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, see, thanks for that, ma'am.
[AGENT][NEUTRAL] Mhm. And what is the next member's policy number?
[CUSTOMER][NEUTRAL] The next member's policy is 001650682 Mike Lima number 8.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] OK, so we've already done this number.
[AGENT][NEUTRAL] What's the um what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Oh, yes.
[CUSTOMER][NEUTRAL] It's for [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is it for a different data service?
[CUSTOMER][NEUTRAL] And the date of birth is on.
[AGENT][NEUTRAL] Uh, go ahead.
[CUSTOMER][NEUTRAL] Yes, different data service. No, actually the data service is also same just the bill amount is different for this one.
[CUSTOMER][NEUTRAL] Shall I provide you with the date of birth?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yes, it's on [PII].
[CUSTOMER][NEUTRAL] And
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Data service.
[AGENT][NEUTRAL] In total bill amount.
[CUSTOMER][NEUTRAL] Uh, it's
[CUSTOMER][NEUTRAL] Yes, it's on [PII].
[CUSTOMER][NEUTRAL] The amount of $3480 even.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK this claim was received on [PII] processed on [PII].
[AGENT][NEUTRAL] Claim number 349.
[AGENT][NEUTRAL] 2145.
[AGENT][NEGATIVE] This claim was also denied.
[AGENT][NEUTRAL] And who, well, what is the, who is the provider on this?
[CUSTOMER][NEUTRAL] Uh, do you need the rendering provider's name for this one, ma'am?
[AGENT][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] Uh, it would be George Casino.
[CUSTOMER][NEUTRAL] Hello, it's a big name, [PII].
[AGENT][NEUTRAL] And what is the provider group?
[CUSTOMER][NEUTRAL] It's Galloway Anesthesia Associates.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And the reason for the denial on this one is the same as the other one for the state of service outpatient benefit for this calendar year has been met.
[CUSTOMER][NEUTRAL] OK, I understand, ma'am.
[CUSTOMER][NEUTRAL] And is the date of uh the dates the same too?
[AGENT][NEUTRAL] Yes it is.
[CUSTOMER][NEUTRAL] OK, I understand. Thank you for that info. And yes, could you like fax us a copy of you for this one too, ma'am?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I will in just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] He's still trying to like this.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Yes ma'am, no problem.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you said that you had one more. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] Uh no, ma'am. That would, that would be it, ma'am. The other one has been already finished. Yes.
[AGENT][NEUTRAL] This is the last time? OK, so I have.
[AGENT][NEUTRAL] OK, so I have just uh faxed that to you, so you should be receiving that one momentarily as well. And again, for any reason, if the fax line were to continue to be busy on any of the ones that hasn't already gone through and it times out, then you can, you know, go to that portal that I gave you and you should be able to easily pull those up with the claim numbers.
[CUSTOMER][POSITIVE] Yes, I understand. Thanks for your assistance for today, ma'am. You've been a great help and I hope you have a great day ahead.
[AGENT][NEUTRAL] And you.
[AGENT][POSITIVE] I hope you do too, [PII], and thank you again for calling APL. I hope you have a very nice evening.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][POSITIVE] Uh, you're welcome. Bye bye.
[CUSTOMER][NEUTRAL] OK