AccountId: 011433970860
ContactId: 7a04c5f5-a68f-4667-a1ca-4e27f9efafb0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 434540 ms
Total Talk Time (AGENT): 98725 ms
Total Talk Time (CUSTOMER): 143868 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/7a04c5f5-a68f-4667-a1ca-4e27f9efafb0_20250122T19:22_UTC.wav
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[AGENT][NEUTRAL] Assist you today?
[CUSTOMER][NEUTRAL] Yeah, I am just calling to check on the status of a couple days of service if their claims have been received.
[AGENT][POSITIVE] I'd be happy to assist with claim status. May I have your first name please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] And [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] The policy number is, sorry, let me get back in here.
[CUSTOMER][NEUTRAL] Policy number is 02129245.
[AGENT][NEUTRAL] Patient's name, date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] And what is the date of service for the claim?
[CUSTOMER][NEUTRAL] So I've actually got a couple for him. The first one is 65-2024.
[AGENT][POSITIVE] Thank you for that information.
[AGENT][NEUTRAL] And one moment, let's see 65 2024.
[CUSTOMER][NEUTRAL] like
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] A 65. I'm sorry, 66 was the data service that it was applied to. he was seen both days.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK, mm.
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] It looks like I was able to fax that claim over back in December.
[AGENT][NEUTRAL] Uh, and what's the, um,
[AGENT][NEUTRAL] Tax ID number?
[CUSTOMER][NEUTRAL] Tax ID is [PII].
[AGENT][NEUTRAL] OK, I'm showing we received a claim for [PII]. Uh, payment was made in the amount of $780.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] 780.
[AGENT][POSITIVE] $780 that's correct.
[CUSTOMER][NEUTRAL] When was that paid?
[CUSTOMER][POSITIVE] I do that. That was fun.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Beyonce plus
[CUSTOMER][NEUTRAL] Finger
[CUSTOMER][NEUTRAL] Like singers
[CUSTOMER][NEUTRAL] Oh, yeah.
[CUSTOMER][NEUTRAL] So that was paid back in June.
[CUSTOMER][NEUTRAL] For 780?
[AGENT][NEUTRAL] $780 yes.
[CUSTOMER][NEUTRAL] And that was for the SRP on [PII]?
[AGENT][NEUTRAL] What now, yeah, because we have more than one client for that data set so what um.
[AGENT][NEUTRAL] This was for.
[AGENT][NEUTRAL] It looks like the code is.
[CUSTOMER][NEUTRAL] So it looks like they have billings and stuff done that day like the 2331 and 2393. I am looking for the 4341 and the 4999.
[AGENT][NEGATIVE] OK, so the 4999 denied because that is not a covered benefit on the um fax back and the other two lines denied because they had met their max.
[AGENT][NEUTRAL] Um, they have met their, um, calendar year max when we received that claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that claim was received on.
[AGENT][NEUTRAL] That claim was received on [PII] and it denied on [PII].
[CUSTOMER][NEUTRAL] OK, can I get a faxed copy of that EOB?
[AGENT][NEGATIVE] Uh, the one, the denial.
[CUSTOMER][NEUTRAL] Or like a remailed one?
[CUSTOMER][NEUTRAL] Yeah, just so I can send it to secondary.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] 23.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hey [PII], what is happening over here? What's
[CUSTOMER][NEGATIVE] What are you talking about the poor guy.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] Let's go
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] From the
[CUSTOMER][NEUTRAL] Cut it so I have a lot of stick, but I don't understand like.
[CUSTOMER][NEUTRAL] You the
[CUSTOMER][NEUTRAL] It.
[AGENT][NEUTRAL] And what is the fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And to who's attention?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] my
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] Alright, you should receive that fax within the next 20 minutes. Was there anything else I can assist with today?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Can I just check on the same patient data service for [PII]?
[AGENT][NEUTRAL] I'm not sure we have a claim for that data service.
[CUSTOMER][NEGATIVE] I spoke to someone in November and they said that they thought it was pending for a crown on [PII] but you're not showing anything.
[CUSTOMER][NEUTRAL] With
[AGENT][NEUTRAL] No, I don't show anything for [PII].
[CUSTOMER][NEUTRAL] before
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] You said [PII], right?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Yes, we don't have anything on file for that data service.
[CUSTOMER][NEUTRAL] The brain so
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] Mm thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Mhm. Bye bye.
[CUSTOMER][NEUTRAL] It