AccountId: 011433970860
ContactId: 896bc48b-b6f7-406e-ade3-0c73763d809b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 492049 ms
Total Talk Time (AGENT): 122620 ms
Total Talk Time (CUSTOMER): 105457 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/896bc48b-b6f7-406e-ade3-0c73763d809b_20250311T17:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from Boba office. How are you doing today?
[AGENT][POSITIVE] I'm doing good, [PII]. How are you doing today?
[CUSTOMER][POSITIVE] So good so far. Thanks for asking. Actually, we have received the payment uh under a particular check number.
[CUSTOMER][NEUTRAL] But need the CP line item wise CPT break up so that we can post the payment accordingly.
[AGENT][NEUTRAL] OK, [PII], um.
[AGENT][NEGATIVE] I'm having a really hard time hearing you. It's like your microphone is far away.
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][POSITIVE] Uh, now it's better.
[AGENT][NEUTRAL] Yes, that's better thank you. OK, and I'm sorry I didn't catch why you were calling, sir.
[CUSTOMER][NEUTRAL] So basically
[CUSTOMER][NEUTRAL] Yeah, I
[CUSTOMER][NEUTRAL] Uh, actually we have received a payment for a particular data service for a particular patient looking for the line item wise payment breakup so that we can post the payment accordingly. There are two CPT code bill.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But we don't know for which CPT code the payment has been made for.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], I can help you with the payment. Um, can you please give me your callback number?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] Thank you and then what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Florida cancer specialist.
[AGENT][NEUTRAL] OK, and can you give me the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Absolutely, so the policy uh policyholder name is.
[CUSTOMER][NEUTRAL] Just a minute.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] 2300701
[CUSTOMER][NEUTRAL] And the DOB is [PII].
[AGENT][NEUTRAL] OK, let me pull in that policy real quick.
[AGENT][NEUTRAL] OK, and can you repeat the policy number one more time for me, please? I think I missed a digit.
[CUSTOMER][NEUTRAL] 2300701.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] 2300701. Is that correct?
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][NEUTRAL] And it's for [PII].
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] OK, and can you give me the claim number?
[CUSTOMER][NEUTRAL] Uh, instead of claim number, can I provide the date of service and the bill number?
[AGENT][NEUTRAL] Yes, what's the date of service?
[CUSTOMER][NEUTRAL] So the date of service for this particular patient is
[CUSTOMER][NEUTRAL] [PII] with a big charge of
[CUSTOMER][NEUTRAL] $369 even.
[AGENT][NEUTRAL] 369369.
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I'm gonna put you on a quick hold while I look up this claim for you and I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, [PII]. I do have the claim pulled up. The claim number is 356-8210. Claim was paid $50.07 that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The uh code that was not paid was procedure 963-72.
[CUSTOMER][NEUTRAL] So this is the night for what reason?
[AGENT][NEGATIVE] It was denied because the insured's major medical coverage provided full benefits, no.
[AGENT][NEUTRAL] That's for payable for this procedure.
[CUSTOMER][NEUTRAL] So basically the service is not covered, right?
[AGENT][NEGATIVE] No, it's, it's nothing to be paid because the major medical coverage paid for it.
[CUSTOMER][NEUTRAL] So it's a bundle, bundle with the primary code which is already paid.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So basically it's included in the major code, primary CPT code.
[CUSTOMER][NEUTRAL] Already paid.
[AGENT][NEUTRAL] Yes, it was already paid.
[CUSTOMER][POSITIVE] OK. Thank you so much. Can I have your name and I want the call reference number?
[AGENT][NEUTRAL] Yes, my name is [PII] and you can use my name and today's date.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] You're welcome, [PII]. I hope it's A.
[CUSTOMER][NEUTRAL] Initial and last name?
[CUSTOMER][POSITIVE] Thank you. I really appreciate the information provided by you. Have a great day. Stay safe. Bye-bye.
[AGENT][POSITIVE] You too, [PII]. You have a wonderful day and thanks for calling APL.