AccountId: 011433970860
ContactId: 8859659a-a198-4993-b004-7ca23da5a6a8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 528640 ms
Total Talk Time (AGENT): 236438 ms
Total Talk Time (CUSTOMER): 136016 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/8859659a-a198-4993-b004-7ca23da5a6a8_20241230T13:57_UTC.wav
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[AGENT][POSITIVE] Morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII]. I'm calling from Integrated Dermatology of Sunset Drive, and I'd like to check on a couple of claims for this patient. Can I get the first letter to your last name?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Sure. The first letter to my last name is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm. Can I spell my name [PII]
[CUSTOMER][POSITIVE] Oh, OK. Thank you.
[AGENT][NEUTRAL] Hm, and [PII], what is a good callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, [PII], and it would be a pleasure to assist you with claim status. What is the policy number for the patient?
[CUSTOMER][NEUTRAL] That is 02212533 M as in Mary, L as in Lima number 8.
[AGENT][NEUTRAL] Thank you, [PII] and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you, and [PII], what is the data service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what was that bill out for [PII]?
[CUSTOMER][NEUTRAL] $180.59.
[AGENT][NEUTRAL] Thank you. And what is the provider name? Looks like we have the.
[AGENT][NEUTRAL] Uh, rendering provider.
[CUSTOMER][NEUTRAL] A for.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, provide, you mean the
[AGENT][NEUTRAL] Physician name.
[CUSTOMER][NEUTRAL] The fighter was [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have the billing name available?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right, [PII], I am showing that we received that claim on [PII].
[AGENT][NEUTRAL] Processed and paid on [PII].
[AGENT][NEUTRAL] In the amount of $52.33. Now the 99213 was denied as non-covered office visits are not covered by her plan.
[CUSTOMER][NEUTRAL] OK. And let's see.
[CUSTOMER][NEUTRAL] And was that paid on a check or was it paid on EFT?
[AGENT][NEUTRAL] Single paper check.
[CUSTOMER][NEUTRAL] And that was mailed out on what day?
[AGENT][NEUTRAL] It was mailed out on the [PII].
[AGENT][NEUTRAL] Or the next business day it was processed on.
[AGENT][NEUTRAL] The [PII]
[AGENT][NEUTRAL] So it would have gone out on the [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Would you like that claim number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Uh, yeah, that'd be great.
[AGENT][NEUTRAL] Claim number is 352.
[AGENT][NEUTRAL] 7962
[CUSTOMER][NEUTRAL] Thank you. And a reference number?
[AGENT][NEUTRAL] Would be my name and today's date.
[CUSTOMER][NEUTRAL] And how about uh for data service?
[CUSTOMER][NEUTRAL] [PII] billed for $226.58.
[AGENT][NEUTRAL] Yeah, and you said [PII].
[AGENT][NEUTRAL] OK, that claim we received on [PII] and processed on [PII] with a payment of $39.87.
[CUSTOMER][NEUTRAL] OK, because the 99214 is not covered.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. It wasn't, so it wasn't on the same check as
[AGENT][NEUTRAL] No, it's gonna be a different check.
[CUSTOMER][NEUTRAL] think it's a single paper check.
[AGENT][NEUTRAL] Single paper check, you know, and I can give you the check numbers if you'd like.
[CUSTOMER][POSITIVE] OK, that'd be great.
[AGENT][NEUTRAL] So on this claim, let me give you the claim number and check number. Claim number is 352.
[AGENT][NEUTRAL] 7957.
[AGENT][NEUTRAL] Check number is 201.
[AGENT][NEUTRAL] 2803.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On that previous claim, the 352-7962, that's check number 201.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 2808.
[CUSTOMER][NEUTRAL] OK. And where were those checks mailed to?
[AGENT][NEUTRAL] They were mailed to.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you for that. And
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] that was billed for 139-15.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, got you.
[AGENT][NEUTRAL] That claim we received on [PII] and processed on [PII] with the payment of $38.79.
[AGENT][NEUTRAL] And that check number.
[AGENT][NEUTRAL] Is 202.
[AGENT][NEUTRAL] 0114.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the claim number?
[AGENT][NEUTRAL] I'm so sorry, 354.
[AGENT][NEUTRAL] 5012.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and that was mailed out on
[AGENT][NEUTRAL] It was processed on the [PII], so it should be going out today.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] The last one I have is [PII].
[CUSTOMER][NEUTRAL] Bill for 22549.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, and that one also was processed on the [PII], um, received on the [PII] and processed on the [PII] with a payment of
[AGENT][NEUTRAL] $38.74.
[AGENT][NEUTRAL] And that claim number is 354.
[AGENT][NEUTRAL] 5024.
[AGENT][NEUTRAL] And check number 2020115.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Great. Thank you so much, [PII]. I appreciate all your help.
[AGENT][NEUTRAL] That
[AGENT][POSITIVE] Hey [PII], it's been such a pleasure to help you with that claim status. Also, if you need the EOBs, we do have a provider portal at secured. That's SEC.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] It's a self-registration portal using your tax ID number and the patient's account number listed in box 26.
[AGENT][NEUTRAL] And on that portal you'll have 24/7 access to EOBs, claim status, as well as claim submission.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Thank you so much, [PII]. I appreciate it.
[AGENT][POSITIVE] My pleasure, [PII], and thank you for calling APL. I hope you have a wonderful day and a very happy [PII].
[CUSTOMER][POSITIVE] Likewise, thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.