AccountId: 011433970860
ContactId: 9d8635a1-77de-4149-853e-4d51d69cd78e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 503230 ms
Total Talk Time (AGENT): 136936 ms
Total Talk Time (CUSTOMER): 123242 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/9d8635a1-77de-4149-853e-4d51d69cd78e_20250408T18:45_UTC.wav
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[AGENT][NEUTRAL] [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office regarding claim status.
[AGENT][NEUTRAL] OK, can I help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Yeah, that's uh 02487866.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, that's uh [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you. OK, give me just a moment, [PII], OK?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I get better now?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Verify the patient's name and date of birth for me please, [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, the first name is [PII], the last name is [PII], and the date of birth is gonna be [PII].
[AGENT][NEUTRAL] OK, thank you for that information and we're checking a claim status for what data service?
[CUSTOMER][NEUTRAL] Yeah, one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, that's uh [PII].
[AGENT][NEUTRAL] And the total charge?
[CUSTOMER][NEUTRAL] Yeah, uh, one moment. I, I have a little change in the data service that's [PII].
[AGENT][NEUTRAL] [PII] [PII]?
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] mhm and the amount.
[CUSTOMER][NEUTRAL] That's uh $359.66.
[AGENT][NEUTRAL] OK, is this a professional fee or a facility charge?
[CUSTOMER][NEUTRAL] It's a facility.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I'm not showing a facility charge on file for date of service [PII] for 359.66.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can you please try with the different date of service?
[AGENT][NEUTRAL] The one you gave me previously, [PII]?
[CUSTOMER][NEUTRAL] No, that's uh [PII].
[AGENT][NEUTRAL] I'm not showing a facility charge for [PII].
[CUSTOMER][NEUTRAL] Can you please stay with the professional charges?
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Can you please try with the professional charges that you said before?
[AGENT][NEUTRAL] OK, I'm sorry, I didn't understand your question.
[CUSTOMER][NEUTRAL] Yeah, but last time when I have inquired for the claim, uh, I have got the information that the claim is still in process because of the verification criteria, eligibility criteria, so that I, I just now called after 15 days.
[AGENT][NEUTRAL] OK, so you've called APL before to status the data service and you were told that we we have the claim on file.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] for 15 days.
[AGENT][NEUTRAL] Did you get the claim number?
[CUSTOMER][NEUTRAL] One moment. Now, the CSA they didn't provide the claim number.
[AGENT][NEUTRAL] Yeah, I do not see a facility charge for [PII] or [PII].
[CUSTOMER][NEUTRAL] I only have the call reference over here.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What are the procedure codes on the claim?
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] And that's 80562.
[CUSTOMER][NEUTRAL] And it's E 0601.
[CUSTOMER][NEUTRAL] That's RRK X.
[AGENT][NEUTRAL] OK, so is this for DME equipment?
[CUSTOMER][POSITIVE] Yeah, that's right. Yeah, yeah.
[AGENT][NEUTRAL] OK, so this would be a professional fee?
[AGENT][NEUTRAL] And so
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I see a.
[AGENT][NEUTRAL] You said A 0562 and E 0601?
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] OK, so I show that claim under [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One moment. The claim number is 3554145, and what is the DME provider's name?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, it's uh Camden Medical Supply.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so the date of service of [PII] is still pending uh for additional information, so at this moment we've not received the information.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, how much did it, it takes to get processed?
[AGENT][NEUTRAL] It's coming from a different entity so we once we receive it, the claim will the the claims processing will continue, so I can't give you a timeline as to when we'll get it from the entity that we're requesting it from.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But once we receive it, should be, you know, 7 to 10 business days, our standard processing time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Anything else?
[CUSTOMER][POSITIVE] Yeah, thank you so much. Yeah, that's it for today. Thank you so much. Uh, can you please provide the call reference with your name?
[AGENT][NEUTRAL] You'll use my name in today's date as reference for today's call. It's [PII]
[AGENT][NEUTRAL] And the first initial last name is [PII], and when you status a week or two from now if you could provide that claim number 355-4145.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let us know it's for durable medical equipment.
[CUSTOMER][POSITIVE] Yeah. And thank you so much.
[CUSTOMER][NEUTRAL] Mhm, yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, thank you so much. Thank you for assisting me, [PII]. Have a great day. Bye-bye.
[AGENT][POSITIVE] Oh, you're welcome. Thanks.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.