AccountId: 011433970860
ContactId: 7c7a6be5-ac76-4335-af6c-b1c2e6c7c1f9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195660 ms
Total Talk Time (AGENT): 52484 ms
Total Talk Time (CUSTOMER): 115522 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/7c7a6be5-ac76-4335-af6c-b1c2e6c7c1f9_20250314T18:43_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII]. I'm calling from a provider's office, American Anesthesiology Services of Florida, and I was calling to get more information um on a claim on the EOB that we received.
[AGENT][POSITIVE] I'd be happy to assist with claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Sure, my direct line is [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] The policy number 01578526.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] I have [PII], or I'm not sure you said the first name, [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information and what is the date of service for the claim?
[CUSTOMER][NEUTRAL] Data service is.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And the bill amount is $3,357.60.
[AGENT][NEUTRAL] And what is your tax ID?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you for that information. So I'm showing the claim denied because their outpatient benefits was already maxed out before we receive this claim. It looks like the facility.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] When we paid the facility we maxed out the benefits.
[CUSTOMER][NEUTRAL] OK, max one facility was paid.
[CUSTOMER][NEUTRAL] OK, and because I don't, is it possible? I have a copy of the EOB here, but it.
[CUSTOMER][NEUTRAL] It looks like when we received it received it or I'm not sure the way it was scanned into our um lockbox, but it's.
[CUSTOMER][NEUTRAL] Not very clear. I was wondering if it's possible that you can email me a copy of it to my secure email.
[AGENT][NEUTRAL] I can't email the EOB. I can only send it by fax.
[CUSTOMER][NEUTRAL] By fax? OK. And let me just verify because like I said it's not very clear here, but I'm trying to verify was their patient responsibility on the claim.
[AGENT][NEUTRAL] We don't determine patient responsibility. Um, the, the primary does, but since we didn't pay anything, whatever it says on the EOB that you sent us would be the patient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For the primary, mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, OK, yes, because we did bill to the primary and they apply the deductible, so anything that you don't pay, we go by the primary EOB for that.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK. All right, great, and I also.
[CUSTOMER][NEUTRAL] Let me just verify the claim number 35.
[CUSTOMER][NEUTRAL] Looks like
[CUSTOMER][NEUTRAL] 33
[CUSTOMER][NEUTRAL] 236
[AGENT][POSITIVE] 236. Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. OK. All right, thank you. And if I could just get a reference number for the call, please.
[AGENT][NEUTRAL] Reference is just my name [PII], last initial [PII], and the date and time of the call. Was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's it. Thank you for your help.
[AGENT][POSITIVE] Thank you for calling APO you have a good day.
[CUSTOMER][NEUTRAL] You too.