AccountId: 011433970860
ContactId: 65448a1b-92ce-4cdc-9abf-fe52aa761fe8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 399029 ms
Total Talk Time (AGENT): 172923 ms
Total Talk Time (CUSTOMER): 93517 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/65448a1b-92ce-4cdc-9abf-fe52aa761fe8_20250122T19:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] calling from provider office to check claim status. Can you please assist me?
[AGENT][NEUTRAL] Yeah, I can check on a claim for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, callback number is [PII]. Direct line, no extension.
[AGENT][NEUTRAL] Alright, thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, policy number is 02284366.
[AGENT][NEUTRAL] OK, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that [PII] uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] D of service is [PII] for charge amount $465.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry [PII], what was the name of the provider's office?
[CUSTOMER][NEUTRAL] Provider office name is M and K P LLC.
[AGENT][NEUTRAL] OK, thank you. Do you believe I found this claim?
[AGENT][NEUTRAL] Yes, so we paid a benefit of $75 and that did um.
[AGENT][NEUTRAL] Meet their maximum benefit payable for the date of service.
[CUSTOMER][MIXED] OK. Only $75 no patient responsibility.
[AGENT][NEUTRAL] We do not say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] OK. And claim received and processed date as the claim number?
[AGENT][NEUTRAL] Uh yes, so that claim number is 3544025.
[AGENT][NEUTRAL] And it was received [PII].
[AGENT][NEUTRAL] And it was processed [PII].
[CUSTOMER][NEUTRAL] OK. Claim number is 3544025, is it?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And check number issue date?
[AGENT][NEUTRAL] Oh, let me see when that was issued. Give me just a moment.
[AGENT][NEUTRAL] Did you need that check number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so that is 201.
[AGENT][NEUTRAL] 973 8.
[AGENT][NEUTRAL] I said it was issued [PII]. I am showing it is still outstanding, so there is a, it has to be at least 30 days uh from the issue date before we can have this check reissued.
[AGENT][NEUTRAL] But I can confirm the address that it was sent to let me know when you're ready.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the address we have is [PII].
[CUSTOMER][POSITIVE] Yes, the address is correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I guess after tomorrow um we would be able to get that check reissued to you.
[CUSTOMER][NEUTRAL] OK. And uh uh procedure code 99213 is paid for $75.
[AGENT][NEUTRAL] Uh, let's see, 99213, yes, that was what we paid the $75 towards.
[CUSTOMER][NEUTRAL] And 99401.
[AGENT][NEGATIVE] We were unable to pay a benefit. The maximum amount was 75 for this data service.
[CUSTOMER][NEUTRAL] OK, thank you. Uh, I have one more data service for the same patient. Are you ready?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This is for the same number?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK, yeah, what was that other date of service?
[CUSTOMER][NEUTRAL] Date of service is [PII] for the charge amount $175.
[AGENT][NEUTRAL] 75. OK, thank you one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and for this claim, uh, we also paid $75 which was the maximum amount for the state of service, um, I've got that claim number whenever you're ready.
[CUSTOMER][NEUTRAL] Uh yes, that is claim number?
[AGENT][NEUTRAL] It is 354 5.
[AGENT][NEUTRAL] 736
[CUSTOMER][NEUTRAL] 354-573-6, is it?
[AGENT][NEUTRAL] Correct, and this claim was received [PII].
[AGENT][NEUTRAL] And it was processed [PII].
[CUSTOMER][NEUTRAL] OK. Check number and issue date.
[AGENT][NEUTRAL] The check number is 2,020,500.
[AGENT][NEUTRAL] And it was issued [PII] to the same address.
[CUSTOMER][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, yes, thank you. Reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] last [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, thank you.
[AGENT][POSITIVE] Alright, well thanks for calling API. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] OK. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.