AccountId: 011433970860
ContactId: 7b8dceee-4d92-4ca6-a609-54efa7f74258
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 380500 ms
Total Talk Time (AGENT): 101482 ms
Total Talk Time (CUSTOMER): 132289 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/7b8dceee-4d92-4ca6-a609-54efa7f74258_20250422T18:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Uh, thank you so much. This is [PII] speaking calling from your office. I need the claim status.
[AGENT][NEUTRAL] Hey [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, callback number is [PII].
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] And you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, it is 02448913 M for [PII] for Lima, 8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's first name is [PII], last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Uh, the date of birth.
[CUSTOMER][NEUTRAL] And the total charge amount is?
[CUSTOMER][NEUTRAL] Uh, date of birth is [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and build them out?
[CUSTOMER][NEUTRAL] Uh, [PII] and the total charge amount is $2200 even.
[AGENT][NEUTRAL] And what was, who was the provider?
[CUSTOMER][NEUTRAL] Uh, Lake City Surgery Center.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] I'm sorry, what was the total charges again? So sorry about that.
[CUSTOMER][NEUTRAL] Uh, it's OK. That is the
[CUSTOMER][NEUTRAL] $2200 even.
[AGENT][NEUTRAL] Well, I've, I've got a data service for [PII], but it's not for that build amount.
[CUSTOMER][NEUTRAL] Uh, that is 2200.
[AGENT][NEUTRAL] Yeah, I don't show it's for that build amount. Let me pull up what we received. Let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I just have the physician's claim. I don't have a facility claim.
[CUSTOMER][NEUTRAL] Uh, I also rendering provider that is the Adul Kabir.
[AGENT][NEUTRAL] I'm Sorry?
[CUSTOMER][NEUTRAL] Uh, rendering provider name is Adul Kabir.
[AGENT][NEUTRAL] OK, yeah, I have a claim on file, but it's not for the amount that you've given me.
[CUSTOMER][NEUTRAL] Uh, OK, so I think you have the for the left amount for the patient responsibility that is just a minute.
[CUSTOMER][NEUTRAL] Uh, that is the $1,375.17.
[CUSTOMER][NEUTRAL] a
[AGENT][NEUTRAL] Um, I don't show that, so I have, I bill charges are 3280.
[AGENT][NEUTRAL] And then deductible is 1,03595.
[AGENT][NEGATIVE] No, I don't have a plane matching what you're giving me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, can you confirm the your are this
[AGENT][NEUTRAL] I got a claim for that provider.
[CUSTOMER][NEUTRAL] OK, so you, we need to again this some of the claim.
[AGENT][NEUTRAL] Yeah, um, yes, you can resubmit the claim.
[CUSTOMER][NEUTRAL] OK. So can you verify
[CUSTOMER][POSITIVE] OK, thank you so much. Can you verify that you are the secondary for this member?
[AGENT][NEUTRAL] Yes, we are.
[CUSTOMER][NEUTRAL] And you have to also cover for the primary deductible amount.
[AGENT][NEUTRAL] Yes, so we're secondary policy potentially picking up deductible co-pay, co-insurance, yes.
[CUSTOMER][NEUTRAL] OK, thank you so much. So can you verify any remaining for the amount for the second insurance?
[AGENT][NEUTRAL] Verify if there's benefits left for the year, is that what you're asking?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Um, they have a $500 per calendar day benefit.
[AGENT][NEUTRAL] And we've we've exhausted that on a claim for this provider but a different build amount.
[CUSTOMER][NEUTRAL] OK, so you have already, um, a patient have already meet the benefits for the another provider.
[AGENT][NEUTRAL] So for this provider, the provider name you gave me is the claim we have on file, but it doesn't match, it doesn't match the charges you said?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Is there any fax number for uh claim submission?
[AGENT][NEUTRAL] Uh, fax number is [PII].
[CUSTOMER][POSITIVE] Thank you so much and attention to claims department.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you so much. Can you confirm the card reference number?
[AGENT][NEUTRAL] It's my name, [PII], first initial to last name [PII]. Today's date.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you so, thank you so much, [PII]. No, no, that's all. Thank you so much, [PII]. Have a wonderful day. Bye-bye. Thank you so much.
[AGENT][NEUTRAL] Anything else I can help with?
[AGENT][POSITIVE] Thank you for calling APL you as well. Thank you.