AccountId: 011433970860
ContactId: 6eea11b1-5ee8-4b6b-a424-3ffc2d05928c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 593580 ms
Total Talk Time (AGENT): 169303 ms
Total Talk Time (CUSTOMER): 131771 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/6eea11b1-5ee8-4b6b-a424-3ffc2d05928c_20250327T19:25_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office regarding claim status.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status, Mr. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. It's uh [PII]. It's a direct line.
[AGENT][NEUTRAL] OK. And may I have the name of the facility you're calling from for my notation?
[CUSTOMER][NEUTRAL] Yeah, it's uh Camden Medical Supply.
[AGENT][NEUTRAL] OK. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, it's uh 02487866.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, the first name is [PII] and the last name is [PII], and the date of birth is gonna be [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And may I have the date of service and the amount of the time?
[CUSTOMER][NEUTRAL] Yeah, I do have full data service for the same patient.
[CUSTOMER][NEUTRAL] Can you provide all of those?
[AGENT][NEUTRAL] Mhm. Go ahead with the first one.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, the first one is um [PII].
[AGENT][NEUTRAL] How much is the total charge on that one?
[CUSTOMER][NEUTRAL] Yeah, that's uh $156.55.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mr. [PII], for future, you can check claim status online through our website at [PII] and that's just optional. And bear with me, let me pull this EV.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Still waiting on the system. OK, one moment.
[CUSTOMER][POSITIVE] Yeah, sure, take your time.
[AGENT][NEUTRAL] OK. So this claim was processed on [PII] and we send a benefit amount of $44.78. Uh the code 87038 is not covered under the member's plan, that is a disposable supply. Disposable supplies are not covered.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, for the CPT code A 7031.
[AGENT][NEUTRAL] And we've covered $44.78.
[CUSTOMER][POSITIVE] Yeah, thank you so much. Is there any claim number or check number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, the claim number is 3554922.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The check number is 2024078.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, thank you so much. Shall we go on with the next uh date of service?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, what's the next one?
[CUSTOMER][NEUTRAL] And that's uh [PII].
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] Yeah, that's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] How much is the total charge of the claim?
[CUSTOMER][NEUTRAL] Yeah, the total bill amount is $503.53.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] just a minute, let me pull the correct one.
[AGENT][NEUTRAL] OK. Uh.
[AGENT][NEUTRAL] For this one, you said the total charge was how much?
[CUSTOMER][NEUTRAL] Yeah, that's uh
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's $503.53.
[AGENT][NEUTRAL] OK, yes. So it looks like we processed the claim on [PII] and we send a benefit amount of $145.13. Again, code [PII] was not covered because we do not cover disposable supplies.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So only that uh CVT code is not good, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And rest of those are paid.
[AGENT][POSITIVE] Correct, the rates are paid.
[CUSTOMER][POSITIVE] Yeah, thank you so much. Um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, the next uh date of service.
[CUSTOMER][NEUTRAL] It's gonna be.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] With the total charge amount of $20283.38.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm waiting on the system, OK?
[CUSTOMER][POSITIVE] Yeah, take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, uh, can you verify the procedure code on this one?
[CUSTOMER][NEUTRAL] Yeah, one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, that's uh
[CUSTOMER][NEUTRAL] There are two CPT codes. Those are E0562 and E0601.
[AGENT][NEUTRAL] OK, so for this one, the last claim I got here was processed on [PII], and we are waiting to confirm eligibility with the employer. So right now it's still pending.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] So it's still losing, right?
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] OK. How much days it takes to get processed?
[AGENT][NEUTRAL] Until we receive this information from the employer.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, thank you so much. So the last uh date of service?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes [PII].
[CUSTOMER][NEUTRAL] With the bill amount of $359.66.
[AGENT][NEUTRAL] OK, so this one is gonna be the same one as the previous one. It's, it's still pending for the information from the employer, OK.
[CUSTOMER][POSITIVE] Yeah, thank you so much. Yeah, that's it for today. Thank you so much. So can you please provide the call reference with your name?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date. My name is [PII] [PII]. Last initial [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, thank you so much. Thank you for assisting me. Happy speaking with you. Have a great day. Bye-bye.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Mm you as so, Mr. [PII]. Thank you for calling EPR. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.