AccountId: 011433970860
ContactId: 83d4f395-ba1c-420a-ae6b-467db19eb7a0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 358820 ms
Total Talk Time (AGENT): 90102 ms
Total Talk Time (CUSTOMER): 150089 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/83d4f395-ba1c-420a-ae6b-467db19eb7a0_20250624T20:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi this is [PII] calling from provider office for a claim information.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with claim status first. Could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, the callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Now, I need the policy number.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, the member policy number it's going to be 025767.
[CUSTOMER][NEUTRAL] 22.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] The patient's name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth on [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The date of service on [PII]. The charge amount on the claim is $156.06.
[AGENT][NEUTRAL] OK, we received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number is 361-3842.
[AGENT][NEUTRAL] And the claim denied because office visits are not covered under the patient's claim.
[CUSTOMER][NEUTRAL] What you yeah.
[CUSTOMER][NEUTRAL] So they you say the office visit will not cover for the patient's plan, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, so just to confirm.
[CUSTOMER][NEUTRAL] Uh, just give me a moment. I will verify whether that, uh, the claim has been billed any with modified or not. Just give me a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, thank you for your patience. I do see, uh, uh, there's no real modifa or nothing has been built. So is that possible we can build that, uh, with modifa or any connections with that additional for this supporting service.
[AGENT][NEUTRAL] Yes, you can resubmit the claim if you need to.
[CUSTOMER][NEUTRAL] OK, uh, may I have the details for character claim, whether what is the timely filing to submit the character claim?
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] OK, thank you so much for confirming that. And uh just you know, may I have your name with the last initial before moving to the next screen?
[AGENT][NEUTRAL] My name is [PII]. It's spelled [PII] Last initial is [PII], and today's date is your reference number.
[CUSTOMER][NEUTRAL] Thank you so much for confirming that A. And I do have another claim for this number as same, uh, for a different date of service. Could you please provide me the details?
[AGENT][NEUTRAL] Yes, what's the date of service?
[CUSTOMER][NEUTRAL] Yeah, the delivery service on [PII].
[AGENT][NEUTRAL] No bill charges?
[CUSTOMER][NEUTRAL] The billing charges is $253.68.
[AGENT][NEUTRAL] OK, we received this claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number is 3604723.
[AGENT][NEGATIVE] And this claim also denied um
[AGENT][NEUTRAL] Office visits are not covered under the patient's plan.
[CUSTOMER][NEUTRAL] OK, got it. And just to confirm the claim number is 3604723, is that right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, thank you so much for confirming that. And may I have the copy of EOB to my fax number?
[AGENT][NEUTRAL] Yes, what's your fax number?
[CUSTOMER][NEUTRAL] The fax number is [PII] and you can mention the patient's uh last name and the claim number as the attention because it will be easy to find out on our end.
[AGENT][NEUTRAL] So the patient's last name and the claim number, attention it, that's what I attention it to.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. You should receive it in about 10 minutes. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Uh, that's all from my end, uh, that, uh, thank you so much for the information and for the facts. Have a wonderful rest of the day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL and bye.
[CUSTOMER][NEUTRAL] How
[CUSTOMER][NEUTRAL] Bye.