AccountId: 011433970860
ContactId: a378e4b3-a492-4525-b6d7-4c3fb65e84c9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2493830 ms
Total Talk Time (AGENT): 407076 ms
Total Talk Time (CUSTOMER): 1090096 ms
Interruptions: 6
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/a378e4b3-a492-4525-b6d7-4c3fb65e84c9_20250529T20:31_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office, checking on the claim status.
[AGENT][NEUTRAL] OK, well I can verify claim status for you and [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Uh, one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Is on uh.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes, uh, it would be.
[CUSTOMER][NEUTRAL] 25921.
[AGENT][NEUTRAL] No, sir, it's not one of our policy numbers. Sounds like a group number. Do you have a copy of the card in front of you?
[CUSTOMER][NEUTRAL] 01 moment.
[CUSTOMER][NEUTRAL] OK, let me check that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, give me one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh, still loading. One moment. I don't know why what happened.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, let's move to another member. I'm not sure what happened to this number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Oh my God.
[CUSTOMER][NEGATIVE] My system is slow. One moment.
[AGENT][NEUTRAL] That's fine.
[CUSTOMER][POSITIVE] OK. Thanks for your patience.
[CUSTOMER][NEUTRAL] Yes, ma'am ID would be 01299855.
[CUSTOMER][NEUTRAL] M like Mary, L like Lima, number 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have a callback number?
[CUSTOMER][NEUTRAL] Yes, I do. Uh [PII] and extension would be [PII].
[AGENT][NEUTRAL] OK. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Patient name would be [PII] and uh date of birth would be [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Uh, date of service would be [PII] with the charge amount of $3,045 even.
[AGENT][NEUTRAL] OK, and do you have the balance after primary has processed the claim?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and that amount is?
[CUSTOMER][NEUTRAL] $55.
[AGENT][NEUTRAL] OK and the name of the provider's office?
[CUSTOMER][NEUTRAL] OK, one moment. Uh let me check. Uh, meanwhile, could you please spell out your name?
[AGENT][NEUTRAL] [PII] last initial [PII]
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Correct. And the name of the provider's office?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Galloway anesthesia Associates.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] If you want it.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, OK, same date on.
[AGENT][NEUTRAL] Uh, don't show we received that claim. Can you verify the mailing address it was submitted to?
[CUSTOMER][NEUTRAL] Yeah, so one moment.
[CUSTOMER][NEUTRAL] Uh, we submitted one moment and let me check.
[CUSTOMER][NEUTRAL] Yeah, payer ID would be 60801.
[AGENT][NEUTRAL] Uh, that is correct. So you can resubmit the the payer ID or you can you verify the mail address so I can give our fax number.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK, sure. Um, one moment.
[CUSTOMER][NEUTRAL] May I know the claim's mailing, uh sorry, uh, may I know the member's effective date?
[AGENT][NEUTRAL] [PII], policy is active.
[CUSTOMER][NEUTRAL] Plan to date.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] [PII] and selective. OK.
[CUSTOMER][NEUTRAL] And my, uh, pay ID would be 60801, right?
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, may I get the fax number is it?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, may I also get the mailing address?
[AGENT][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. Uh-huh.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK, may I also get the time refilling limit?
[AGENT][POSITIVE] Uh, there is a timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Got you. May I get the
[CUSTOMER][NEUTRAL] Oh, OK. May I get the reference number for this number?
[AGENT][NEUTRAL] Uh, you may use my name in today's date.
[CUSTOMER][NEUTRAL] OK. I do have more claims to check for different member. Uh, shall we go ahead?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, what's next policy number?
[CUSTOMER][NEUTRAL] OK one moment let me pull that up.
[CUSTOMER][NEUTRAL] OK. Next member ID would be 02491434 M like Mary, L like Lima 8.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] Patient's name would be
[CUSTOMER][NEUTRAL] Uh, [PII] Aide and the date of birth would be [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] [PII] with the charge amount of $1720 even.
[AGENT][NEUTRAL] OK, balance after primary.
[CUSTOMER][NEUTRAL] Um, it will be.
[CUSTOMER][NEUTRAL] Uh, one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. $298.48.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And was this for a facility or physician charges?
[CUSTOMER][NEUTRAL] OK, let me check.
[CUSTOMER][NEUTRAL] Uh, it is for Gastro Health LLC.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm showing the claim process as needing a detailed EOB.
[CUSTOMER][NEUTRAL] OK, uh, come in.
[AGENT][NEUTRAL] The claim processed as needing the detailed EOB.
[CUSTOMER][NEUTRAL] Of primary, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, one moment. May I know the claim receive date?
[AGENT][NEUTRAL] I received [PII].
[CUSTOMER][NEUTRAL] [PII] and uh uh denied, right?
[AGENT][NEUTRAL] Yes, we're needing primary, a detailed primary EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. May I know the date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, one moment. It required primary UP OK.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] May I know the claim number?
[AGENT][NEUTRAL] 3542646
[CUSTOMER][NEUTRAL] OK, got you, one moment.
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] OK. Uh, is there any, actually it was previously denied and, uh, uh, we, we submitted the UOB, uh, do you see any UB there?
[AGENT][NEUTRAL] Uh, the claim was processed as a duplicate, so again, we did not receive a detailed EOB which is needed.
[CUSTOMER][NEUTRAL] OK. May I know the uh recent received date?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Uh, received [PII], process [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Denied for denied as duplicate, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, got you. Many of the time frame.
[AGENT][NEUTRAL] There is no time limit to submit claims.
[CUSTOMER][NEUTRAL] To submit the primary OB?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, sure. Same, the same, uh, uh, information, right? Payer ID and uh uh fax number?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][NEUTRAL] I'm done, uh, with this number. I may get the contact number. OK, OK, number the same. OK. Shall we move to another data service for a different number?
[AGENT][NEUTRAL] OK, what is the policy number?
[CUSTOMER][NEUTRAL] One moment, let me pull that up.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It would be 01989.
[CUSTOMER][NEUTRAL] 414 M like Mary, L like Lima, number 7.
[AGENT][NEUTRAL] OK, patient's name, date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] and their date of birth would be [PII].
[AGENT][NEUTRAL] OK, data service amount of the charge.
[CUSTOMER][NEUTRAL] Uh, charge amount, uh, data service would be [PII] with the charge amount of $3,533 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] Uh-huh. It would be $953.11.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, uh, insurance claims processes benefits of max for that data service.
[CUSTOMER][NEUTRAL] OK. May I know the claim received date?
[AGENT][NEUTRAL] Uh, received [PII].
[CUSTOMER][NEUTRAL] Mm mhm. cause it and denied on?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, so you stated that maximum benefits has been met, right? So was it a dollar or uh any other?
[AGENT][NEUTRAL] It's a dollar amount.
[CUSTOMER][NEUTRAL] Visits or dollar.
[CUSTOMER][NEUTRAL] OK. May I know the Del amount?
[AGENT][NEUTRAL] Uh, not guaranteed payment. They have, uh, had a benefit max up to 1000 per day.
[CUSTOMER][NEUTRAL] Per day, right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So, when it was made?
[AGENT][NEUTRAL] I can't give you that information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No problem. Um, may I, may I get your B through fax?
[AGENT][NEUTRAL] What's your fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and that's [PII]?
[CUSTOMER][POSITIVE] Exactly.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else with it?
[CUSTOMER][NEUTRAL] Make it the turnaround time to receive the fax.
[AGENT][NEUTRAL] It'd be sent before the end of the day. And so, is this it with this insured or is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Yes, uh, for this member I'm done with this number. So, uh, you know, basically it is a patient responsibility, right?
[AGENT][NEUTRAL] We don't give patient responsibility, we only verify how the claim was processed.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK. May I know the claim number?
[AGENT][NEUTRAL] 349-48004.
[CUSTOMER][NEUTRAL] OK, got you. I do have a few more claims to check.
[CUSTOMER][NEUTRAL] Uh, one moment. Shall we move to another member?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One moment, please.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] These mothers getting on my last nerves.
[AGENT][NEUTRAL] Next policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, it would be 01578521 M like Mary, L like Lima 8.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] Patient's name would be [PII]. Date of birth would be [PII].
[AGENT][NEUTRAL] OK, data service amount of the charge.
[CUSTOMER][NEUTRAL] OK. The service would be [PII] with the charge amount of $2,253 even.
[AGENT][NEUTRAL] Uh, get that data service again.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what is the balance after primary?
[CUSTOMER][NEUTRAL] Uh, it would be $621.30.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, maximum benefits met, right? Uh, make it the claim num uh sorry, uh, claim your date.
[AGENT][NEUTRAL] They are showing that claim process as the outpatient benefit has maxed for the calendar year.
[AGENT][NEUTRAL] Sure. Claim received on [PII], processed on [PII].
[CUSTOMER][NEUTRAL] OK, [PII]. 1 moment.
[CUSTOMER][NEUTRAL] 22, 25. OK.
[CUSTOMER][NEUTRAL] OK, so was it $8 or visits?
[AGENT][POSITIVE] Dollar value. They had a benefit max of up to $1250 per calendar year for outpatient and they've already met that max.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK, dollar, right. May I know the amount?
[AGENT][NEUTRAL] 1250 per calendar year.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] 1250. Got you. Uh, may I know when it was made?
[AGENT][NEUTRAL] No, I can't give you that information.
[CUSTOMER][NEUTRAL] Last mid date.
[CUSTOMER][NEUTRAL] OK, just to make sure I'm asking, I need to document everything. That's why I'm asking. OK. May I know the claim number?
[AGENT][NEUTRAL] I understand, but I can't give you that information. Sure, claim number 3592045.
[CUSTOMER][POSITIVE] OK, OK, no, no problem.
[CUSTOMER][NEUTRAL] Uh, even though you are, uh, you know, you are not providing, I need to ask, that is, uh, that is what we follow.
[AGENT][NEUTRAL] I understand, but I cannot give you that information again.
[CUSTOMER][POSITIVE] Oh, OK, no problem.
[CUSTOMER][NEUTRAL] OK. OK, got you, got you. No problem. OK, for the same date of service, I do have one more claim for this member, um, same data service, same member, uh, charge amount would be.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Before that, may I request you be through fax for previous dollar amount $2,253?
[AGENT][NEUTRAL] OK, the fax that EOB to you. OK, and what is the next date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Yeah, I think
[CUSTOMER][NEUTRAL] Uh, $1,362 even and date of service [PII], same patient.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] Uh, it would be $297.39.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And that claim also processes the outpatient benefit of max for the calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the claim disput date?
[AGENT][NEUTRAL] Uh, the same, uh, received [PII] process on [PII].
[CUSTOMER][NEUTRAL] OK, got you. May I know the claim number?
[AGENT][NEUTRAL] 3,592,040.
[CUSTOMER][NEUTRAL] Got you. Uh, so, uh, same dollar amount, right? 12, uh, sorry, $1250 calendar.
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] The dollar value would be the same, right?
[AGENT][NEUTRAL] Yes. This is on the same policy on the same patient, their outpatient benefit will be the same.
[CUSTOMER][NEUTRAL] OK, uh,
[CUSTOMER][NEUTRAL] OK. OK, got you, just to make sure. So, may I also request the your Brofa?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Thank you. OK, shall we move to next date of service for different member?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] Kind of what script readers get on my nerves.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, what is next policy number?
[CUSTOMER][NEUTRAL] Yeah, it would be 02603938 M like Mary.
[CUSTOMER][NEUTRAL] L like Lima 8.
[AGENT][NEUTRAL] OK, patient's name, date of birth?
[CUSTOMER][NEUTRAL] Uh, patient's name would be [PII]. Date of birth would be [PII].
[AGENT][NEUTRAL] OK, data service amount of the charge.
[CUSTOMER][NEUTRAL] OK, uh date of service would be.
[CUSTOMER][NEUTRAL] [PII] with the charge amount of $348 even.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] 256351.
[CUSTOMER][NEUTRAL] OK. Uh, let me repeat that date so again just to make sure. [PII] with the charge amount of $348 even.
[AGENT][NEUTRAL] Uh, we have not received that claim. Can you verify the address the claim was submitted to?
[AGENT][NEUTRAL] Yeah, we had not received the claim.
[CUSTOMER][NEUTRAL] OK. Uh, it would be [PII].
[AGENT][NEUTRAL] Uh, that address is incorrect. It changed [PII]. When you're ready, I can give you the correct address.
[CUSTOMER][NEUTRAL] OK. Uh, which is [PII]. OK. One moment.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Uh, may I know the member's policy effective and um if any?
[AGENT][NEUTRAL] Effective date, [PII], policy is active.
[CUSTOMER][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And select. OK. Remaining would be same. OK, one moment. March. Got you.
[CUSTOMER][NEUTRAL] OK, let's move to, uh, 11 moment. Let me check whether I have any claims for this number.
[CUSTOMER][NEUTRAL] January February March.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I understand. OK. Shall we move to next date of service for different number?
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][NEUTRAL] Yeah, one moment, let me pull it up.
[CUSTOMER][NEUTRAL] Yes, it would be 02295955.
[CUSTOMER][NEUTRAL] M as in Mary, [PII].
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] [PII] and the date of birth would be [PII].
[AGENT][NEUTRAL] Data service amount of the charge.
[CUSTOMER][NEUTRAL] A date of service would be.
[CUSTOMER][NEUTRAL] [PII] with the charge amount of $1,362 even.
[AGENT][NEUTRAL] Violence after primary.
[CUSTOMER][NEUTRAL] $65 even.
[AGENT][NEUTRAL] Uh, we have not received that claim. Can you verify the mailing address the claim was submitted to?
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Uh, [PII] MS. OK. Uh, we, I know, I thought we submitted to incorrect one.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Let me also check.
[CUSTOMER][NEUTRAL] 1562.
[CUSTOMER][NEUTRAL] 1362. OK. Uh, for, um for the same date of service, I do have a different bill amount for same member. Uh, you know, uh, before that, may, could the member's plan affect you and term date if any?
[AGENT][NEUTRAL] Effective date [PII], policy is active.
[CUSTOMER][NEUTRAL] OK, [PII]. Got you. OK, for the next date of service would be [PII] with the charge amount of $3,045 even.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] It would be $272.80.
[AGENT][NEUTRAL] We have not received that claim.
[CUSTOMER][NEUTRAL] OK, let me verify that we have.
[CUSTOMER][NEUTRAL] OK, even though it was sent to, OK, incorrect one. OK, got you. Same mailing address and same uh information, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, got you. I do have last 23 claims to check. Uh, one moment. Let me pull up the next number.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, next number I would be [PII].
[AGENT][NEUTRAL] OK. Patient's name, date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] White. Date of birth would be
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Data service amount of the charge?
[CUSTOMER][NEUTRAL] Uh-huh. It would be [PII] with the charge amount of $348 even.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] Uh, $70 even.
[AGENT][NEUTRAL] Name of the provider's office?
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Gastro Health LLC.
[AGENT][NEUTRAL] OK, I'm showing that claim processes office visits are not covered per the patient's policy.
[CUSTOMER][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, may I know the payment received date?
[AGENT][NEUTRAL] Received [PII], processed on [PII].
[CUSTOMER][NEUTRAL] [PII] [PII], got you.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, one minute.
[CUSTOMER][NEGATIVE] No. Outpatient and office visits are not good, right?
[AGENT][NEUTRAL] No, it just processes office visits are not covered for the policy.
[CUSTOMER][NEUTRAL] OK, for offices, it's not covered. OK. May I know the plan type?
[AGENT][NEUTRAL] Secondary supplement.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So could you please fax me the UB and uh may I also get that claim number?
[AGENT][NEUTRAL] Claim number 3591699.
[CUSTOMER][NEUTRAL] OK, 359-1699. Uh, could you please fax me the UB?
[AGENT][NEUTRAL] Sure. What is the next policy number?
[CUSTOMER][NEUTRAL] OK. Uh, let me check whether I have any claims for this member as well. One moment.
[CUSTOMER][NEUTRAL] OK, no other.
[CUSTOMER][NEUTRAL] OK, uh, next number ID let me a moment.
[CUSTOMER][NEUTRAL] OK, it would be 1393393 M like Mary, L like Lima number 8.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] [PII] and the date of birth would be [PII].
[AGENT][NEUTRAL] OK, and date of service amount of the charge?
[CUSTOMER][NEUTRAL] The date of service would be [PII] with the charge amount of $2610 even.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Uh, we have not received that claim and the patient was not active at the time of service.
[CUSTOMER][NEUTRAL] 685.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Uh, 2925. May I know the effect on term date if any?
[AGENT][NEUTRAL] Effective date [PII], term date [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] The uh one moment.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII]. So do you see any other um
[CUSTOMER][NEUTRAL] No, uh, insurance is active for this member on the data service.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Um, my man.
[CUSTOMER][POSITIVE] I got you.
[CUSTOMER][NEUTRAL] OK. Shall we move to next state of service for different member?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Oh, sure, sure. Take your time.
[CUSTOMER][NEUTRAL] And.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Sure, sure, sure. Take your time.
[CUSTOMER][NEUTRAL] Like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK. What is the last policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, one moment. It will take 1 to 29. 1 moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thanks for your patience.
[CUSTOMER][NEUTRAL] A robot.
[CUSTOMER][NEUTRAL] Uh, uh, policy number, yeah. Policy number would be 0233.
[CUSTOMER][NEUTRAL] 6060.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] Uh patient name would be [PII].
[CUSTOMER][NEUTRAL] Date of birth of the moment let's check.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah, uh, [PII].
[AGENT][NEUTRAL] OK, data service amount of the charge.
[CUSTOMER][NEUTRAL] Uh-huh. [PII] with the charge amount of $10,000 even.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh OK, let me check that.
[CUSTOMER][NEUTRAL] Yeah, it would be
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] $868.34.
[AGENT][NEUTRAL] I do not sure we received that claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh let me repeat that data. So it's again [PII].
[AGENT][NEGATIVE] We have not received the claim.
[CUSTOMER][POSITIVE] OK, no problem. Make it the members effective and time to define.
[AGENT][NEUTRAL] Effective date, March, I'm sorry, [PII], policy is active.
[CUSTOMER][NEUTRAL] [PII]. I'm still active. OK. Got you.
[CUSTOMER][NEUTRAL] For this member, I do have one more claim to check.
[AGENT][NEUTRAL] Data service, amount of the charge.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah, [PII] with the charge amount of $22,065.10.
[AGENT][NEUTRAL] And we have not received that claim.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, got you. I'm done. Thanks for your assistance. You have a great day. Bye for now.
[AGENT][POSITIVE] You're welcome thank you for calling APL bye.