AccountId: 011433970860
ContactId: a58af4ee-892c-4bb8-9a21-7182e63a8407
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 850950 ms
Total Talk Time (AGENT): 154208 ms
Total Talk Time (CUSTOMER): 389549 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/a58af4ee-892c-4bb8-9a21-7182e63a8407_20250512T14:05_UTC.wav
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[AGENT][NEUTRAL] On APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check the status of the claim.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah, and the callback number, it is [PII].
[AGENT][NEUTRAL] And the other policy.
[CUSTOMER][NEUTRAL] And uh also, can you please
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] So, before that, can you please help me with your name?
[AGENT][NEUTRAL] [PII], it's [PII]
[CUSTOMER][NEUTRAL] [PII], right?
[CUSTOMER][NEUTRAL] And the initial your last name, please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Thank you. And going with the policy number?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] It is 01780690. M as in Mike, L as in Lima, number 8.
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] modify
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] Yeah, yeah, sure.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, could you give me that policy number again? I didn't pull that up.
[CUSTOMER][NEUTRAL] 017
[CUSTOMER][NEUTRAL] 86, sorry, 01780690. M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's last name it is [PII] and first name it is [PII].
[CUSTOMER][NEUTRAL] Your name is and the date of birth is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And date of service and bill charges.
[CUSTOMER][NEUTRAL] Data service, it is uh [PII], 2024. And going with the bill amount, it is uh $16,719 even.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, let me pull that up.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] April.
[CUSTOMER][NEUTRAL] OK OK
[AGENT][NEUTRAL] OK, it looks like we received that claim on 10-2-2024. Process 104.
[CUSTOMER][NEUTRAL] Can you repeat one second? Oh sorry, can you repeat one second?
[AGENT][NEUTRAL] We received it on 102-2024.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Process 104 2024.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] We need an explanation of benefits from 351.
[CUSTOMER][NEUTRAL] Claim number?
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] 3902.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 3902. So, uh the claim, uh, the reason is requesting for primary you will be, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] course
[CUSTOMER][NEUTRAL] Uh, one of the previous user has sent it to you. Have you received it?
[AGENT][NEGATIVE] We have not received it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we need to send it again, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Can you please uh provide me the fax number?
[AGENT][NEUTRAL] Fax number is [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII]. Just one minute.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, uh, can you please, uh, provide me the call reference number for this call?
[AGENT][NEUTRAL] It's my name is [PII], and today's date.
[CUSTOMER][NEUTRAL] OK. And uh can you please help me with more 4 claims on this call? I'm having more 4 claims to take the status.
[AGENT][NEUTRAL] For this patient or a different one?
[CUSTOMER][NEUTRAL] Oh, I have to check. Just give me one minute.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] And this claim is, it is for different patient.
[AGENT][NEUTRAL] OK. Give me one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][POSITIVE] good
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] Yes, sir. The policy number is 025.
[CUSTOMER][NEUTRAL] 11179 M as in Mike, L as in Lima, number 7.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient, uh last name it is uh
[CUSTOMER][NEUTRAL] [PII], first name [PII]
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][NEUTRAL] D of service and bill charges.
[CUSTOMER][NEUTRAL] D of service [PII]. The total bill amount uh $152,0013 even.
[AGENT][NEUTRAL] Uh, we need a copy of the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK. And when the claim was received?
[AGENT][NEUTRAL] You've done 2 1725, process 2 1825.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you please provide me the claim number?
[AGENT][NEUTRAL] 356-519-2.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] 92. OK. And uh this is also signed the previous that has sent the explanation of benefits. Have you received it?
[AGENT][NEUTRAL] Yeah, I'm not.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So we need to send it again to the previous uh fax number what you have provided, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, thank you. Uh shall we move with another one?
[AGENT][NEUTRAL] Yes, what's the policy number?
[CUSTOMER][NEUTRAL] Yeah, I'm going with the policy number.
[CUSTOMER][NEUTRAL] The policy number 01930691 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Patient's last name, uh [PII]. First name, [PII]. Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] State of service and bill charges.
[CUSTOMER][NEUTRAL] Date of service, [PII]. The bill amount is $12,839 even.
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] It it was received on [PII] process 2-11-2025.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The claim number?
[AGENT][NEUTRAL] The number is 356-2350.
[AGENT][NEUTRAL] And it looks like these services are not covered under the plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry, can you repeat once again?
[AGENT][NEUTRAL] Services are not covered under the plan.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Services or
[CUSTOMER][NEUTRAL] Uh, whose plan it is, uh, patient's plan or provider's plan?
[AGENT][NEUTRAL] The patient's plan?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. The patient has any other insurance?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, let me see, hold on one moment.
[AGENT][NEUTRAL] It, it, they have their primary insurance.
[CUSTOMER][NEUTRAL] OK. A primary, which is completed, right?
[AGENT][NEUTRAL] Primary is
[AGENT][POSITIVE] So well net
[CUSTOMER][NEUTRAL] OK. Um, OK. Uh, can you please tell me, uh, total charges for patients responsibility?
[AGENT][NEUTRAL] Um, we can't determine patient responsibility. This is a secondary policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you. And the call reference number will be uh your name and the date, right?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I just, yeah, shall we move with another one?
[AGENT][NEUTRAL] Yeah, what's the number?
[CUSTOMER][NEUTRAL] Going with the other tax ID, sorry, uh the policy number 02.
[CUSTOMER][NEUTRAL] 444-783.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's last name [PII]. First name [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] Data service and bill charges.
[CUSTOMER][NEUTRAL] Data service, uh [PII]. Going with the bill amount, it is $21,487 even.
[CUSTOMER][NEUTRAL] you know.
[AGENT][NEUTRAL] Oh, that was received on.
[AGENT][NEUTRAL] [PII] process 3 [PII] 2025.
[CUSTOMER][NEUTRAL] OK. Claim number?
[AGENT][NEUTRAL] 574253
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] 4253. OK, then claim is denied for?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] We need a primary EOB showing the breakdown of how it was applied to deductible copay and co-insurance.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we need to send it to you, uh, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, this is also sent by our user. Haven't you haven't received it?
[AGENT][NEUTRAL] No, we, we need it to show the breakdown of how it was applied to deductible, co-pay and co-insurance. We have not received that.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK. Thank you very much. So we'll be sending it to you again with the fax number you have provided to the previous one, OK?
[CUSTOMER][NEUTRAL] Oh, and, uh, moving to the last one.
[CUSTOMER][NEUTRAL] Can I go with the policy number?
[AGENT][NEUTRAL] OK. What is it?
[CUSTOMER][NEUTRAL] Yeah. It is 0246.
[CUSTOMER][NEUTRAL] 2236. M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's last name [PII], first name [PII] Date of birth [PII].
[AGENT][NEUTRAL] Date of service and bill charges.
[CUSTOMER][NEUTRAL] Date of service [PII]. Bill amount is $14,740 even.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] That was received [PII], process [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Same date, right?
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Claim number?
[AGENT][NEUTRAL] 3558928
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] A copy of the primary explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, this is, this is also sent by the previous user, you haven't received it?
[AGENT][NEGATIVE] We have not received it.
[CUSTOMER][POSITIVE] OK. So we'll be sending it to you again. Uh, thank you very much, uh, [PII], for helping with this information with the patient. Uh, thank you very much.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Bye. Thank you.