AccountId: 011433970860
ContactId: 7eb24ee8-c1c2-4705-bf9d-0310a337428b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 422820 ms
Total Talk Time (AGENT): 144816 ms
Total Talk Time (CUSTOMER): 178781 ms
Interruptions: 3
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/7eb24ee8-c1c2-4705-bf9d-0310a337428b_20250106T18:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Broader's office to check on the general claim status.
[AGENT][NEUTRAL] I can help you [PII] you said it's for a claim status?
[CUSTOMER][POSITIVE] You're right.
[AGENT][NEUTRAL] Mhm. I can get the policy number and then a good phone number in case we're disconnected.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] My policy number is going to be 1524156 M like Mary, I like India 7.
[AGENT][NEUTRAL] 152 456. What came after 6?
[CUSTOMER][NEUTRAL] I will help you with one more time. 152-4156 M like Mary, I like India number 7.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Got it. And what is the callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] I didn't like that.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, [PII]. What the date of birth, [PII].
[AGENT][POSITIVE] OK, thank you for that information, uh, [PII], and provide the date of service and the total charge, and then I can provide the status.
[CUSTOMER][NEUTRAL] Provider name is going to be the gastro LLC and sorry come again what did you ask me.
[AGENT][NEUTRAL] The data service and total bill.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 627 of 2024 with the amount of $2,788 even.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Actually for these particular patient, we bill the claim in the month of [PII] and um
[CUSTOMER][NEUTRAL] I just spoke with some other representative. She stated that it was in the month of [PII] and it was denied, stating.
[CUSTOMER][NEUTRAL] You need to update COP.
[CUSTOMER][NEUTRAL] I think so just help me with the gender claim status.
[AGENT][NEUTRAL] We needed a more detailed explanation of benefits, is that what you said?
[CUSTOMER][NEUTRAL] Yeah, yeah, I need to know the complete information about that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like that information was received [PII], processed on the [PII]. Is this Gastro Health LLC?
[CUSTOMER][NEUTRAL] Just a second. Just a second.
[CUSTOMER][NEUTRAL] Yeah, this is for the gas LLC and um may I know when did you receive the claim?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, those are the dates that I just gave, received on the [PII], processed on the [PII].
[AGENT][NEUTRAL] The payment is 4004.
[CUSTOMER][NEUTRAL] Uh, actually, we were billed in the month of, no, actually we are billed in the month of [PII], right? Just give me a second.
[AGENT][NEUTRAL] The payment is
[AGENT][NEUTRAL] OK, we received the ELB and processed it on [PII].
[CUSTOMER][NEUTRAL] Actually we
[CUSTOMER][NEUTRAL] OK. OK, just a second.
[CUSTOMER][NEUTRAL] [PII] you are processed.
[AGENT][NEUTRAL] Received [PII], processed [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Payment amount is 440.
[CUSTOMER][NEUTRAL] Claim allowed amount?
[AGENT][NEUTRAL] The payment amount is $441.32.
[CUSTOMER][NEUTRAL] $141 for this.
[AGENT][NEUTRAL] Did you need the check number?
[CUSTOMER][NEGATIVE] Just a thing, just a thing, don't wanna go like.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Don't go too fast. Just give me a second. Actually, you will receive the UB in the month of [PII], and you will process it on [PII]. The claim processed and allowed $441.32 right?
[AGENT][NEUTRAL] That's not the allowed amount, that's the amount of the APL payment.
[CUSTOMER][NEUTRAL] OK, what about the loan amount then?
[AGENT][NEUTRAL] OK, that information is on the ELB that was submitted with the claim. That's where you will get the allowed amount.
[AGENT][NEUTRAL] For each code.
[CUSTOMER][NEUTRAL] OK, you only need the payer $441.32. There is any patient responsibility?
[AGENT][NEUTRAL] We do not determine patients responsibility.
[CUSTOMER][NEUTRAL] Mhm, just a sec.
[CUSTOMER][NEUTRAL] It was paid under Chakorati?
[AGENT][NEUTRAL] Individual check. The check number is 201.
[CUSTOMER][NEUTRAL] Go ahead with the check number?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 854 7.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I know when it was issued?
[AGENT][NEUTRAL] On the [PII].
[CUSTOMER][NEUTRAL] Single check or check.
[AGENT][NEUTRAL] That individual check.
[CUSTOMER][NEUTRAL] OK that's.
[CUSTOMER][NEUTRAL] Can you please verify the pay to address?
[AGENT][NEUTRAL] OK, it's gonna be the billing address on your claim. Could you verify that for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That is the address it was mailed to.
[CUSTOMER][NEUTRAL] Help me with the claim number.
[AGENT][NEUTRAL] That claim number is 3541218.
[CUSTOMER][NEUTRAL] 3541218, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Call reference number for the number?
[AGENT][NEUTRAL] It's gonna be my name and today's date, [PII].
[CUSTOMER][NEUTRAL] Can you please
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] First initial last name is [PII], and you can also check your claim status on the online service center. Um, I can give you the web address, let me know when you're ready.
[CUSTOMER][NEUTRAL] Can you please fax us the UB? Just a second. Just a second. Can you please help me with the, can you please fax us the UB?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Can you please fax us the EOB?
[AGENT][NEUTRAL] OK, that's what I was just saying. It was mailed out on the [PII], so you may not have received it yet, and you can also download it from our online service center. I can give you that web address.
[AGENT][NEUTRAL] Let me know when you're ready.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Can you please just help me, uh, that the payment was cashed out.
[AGENT][NEGATIVE] The check hasn't been cashed it's still outstanding.
[CUSTOMER][NEGATIVE] So it was not casted out.
[AGENT][NEUTRAL] We're not showing it cached.
[CUSTOMER][NEUTRAL] So sorry, you're saying that it was not cleared, right?
[AGENT][NEGATIVE] The same thing, it hasn't cleared the bank. That means it has not been cashed.
[CUSTOMER][POSITIVE] Thanks for that. Have a great day. Bye-bye.
[AGENT][POSITIVE] You're welcome thanks for calling APL, [PII]. Have a good day.