AccountId: 011433970860
ContactId: 9341d080-5814-4a3b-89a3-17d5c8822de9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 400200 ms
Total Talk Time (AGENT): 83026 ms
Total Talk Time (CUSTOMER): 156734 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/9341d080-5814-4a3b-89a3-17d5c8822de9_20250506T16:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, my name is [PII] calling from a provider's office and I just talked to you. I have a couple claims I'm needing, uh, assistance on, please.
[AGENT][NEUTRAL] OK. Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, I do. It is 350641.
[AGENT][NEUTRAL] And then do you have a good callback number?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, uh, what was that policy number again? I pulled up a different name. I must be missing something.
[CUSTOMER][NEUTRAL] 0 350641.
[CUSTOMER][NEUTRAL] Make sure what we have is correct.
[AGENT][NEUTRAL] I'm pulling that up, um.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] You have a social?
[CUSTOMER][NEUTRAL] Well, I do, yes, [PII].
[CUSTOMER][POSITIVE] Interesting.
[CUSTOMER][NEGATIVE] He doesn't even have this policy.
[AGENT][NEUTRAL] And you said [PII], is that right?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Uh, it looks like it's 650641.
[CUSTOMER][NEUTRAL] Oh God, I was just sitting here looking through his chart, yep, that's what it is. Maybe that might be part of the problem.
[CUSTOMER][NEUTRAL] I'm looking for a claim to see if it's been received.
[AGENT][NEUTRAL] Uh, what was the data service and bill charges?
[CUSTOMER][NEUTRAL] Yes, [PII] $532.
[AGENT][NEUTRAL] Uh, did you have his date of birth?
[CUSTOMER][NEUTRAL] I do [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Let's see, did that have um multiple charges on it?
[CUSTOMER][NEUTRAL] It did, yes, there are 4 line items on this claim.
[AGENT][NEUTRAL] OK, uh, looks like we received that on.
[AGENT][NEUTRAL] [PII] and we made a payment.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] Made a payment on [PII].
[AGENT][NEUTRAL] Um, a payment was made to the patient, so you'll have to contact them for information on payment.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, uh, is there an ELB you can send to me?
[CUSTOMER][NEUTRAL] I'm surprised the payment was made to the patient.
[CUSTOMER][NEUTRAL] Especially since we accepted assignment.
[AGENT][NEUTRAL] Um, what's the, what's your facts?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK. And was there another uh date of service on this patient or a different one?
[CUSTOMER][NEUTRAL] Um, well, one last question, can you tell me the amount of the, that was paid to the patient?
[AGENT][NEUTRAL] Uh, looks like it just paid 46.
[CUSTOMER][NEUTRAL] OK, is that typical that you pay the patient and not the provider?
[AGENT][NEUTRAL] Um, it just depends on how it was received and submitted, um.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm, OK, well we submitted it by paper and we did [PII] accept assignment I don't know.
[AGENT][NEUTRAL] Let me see
[CUSTOMER][NEUTRAL] OK, well, I will, well, we'll await that and then we'll have to uh send him a bill so OK um I do have a different patient.
[CUSTOMER][NEUTRAL] To look at.
[AGENT][NEUTRAL] OK, what's that number?
[CUSTOMER][NEUTRAL] And whenever you are ready I'm ready. OK, [PII].
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Yes, this is for [PII], total charge of $209.
[AGENT][NEUTRAL] Uh, it looks like we received that 3-10-2025, process 312 2025.
[AGENT][NEGATIVE] And it was denied, so we're not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And if I could please get that faxed to me, I would appreciate it.
[AGENT][NEUTRAL] OK, I'll get that faxed over.
[CUSTOMER][NEUTRAL] I don't know why we're not getting this. OK, well [PII], I appreciate all of your time and your help. Thank you very much.
[AGENT][POSITIVE] Thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] Uh huh you too bye bye.