AccountId: 011433970860
ContactId: a9a23077-47e1-494f-a43f-e8520502c92b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2993479 ms
Total Talk Time (AGENT): 664611 ms
Total Talk Time (CUSTOMER): 531094 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/a9a23077-47e1-494f-a43f-e8520502c92b_20250313T19:22_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling you from the provider's office to check claim status for this number.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, Ms. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. The callback number is [PII].
[AGENT][NEUTRAL] And may I have the name of the facility you're calling from for my notation?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah, yeah. I'm calling you from the Galloway anesthesia Associate.
[AGENT][NEUTRAL] I got away anesthesia.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah. Just give me a second. I will provide you the policy number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] The policy number is 02337113 M as in M, L as in lion 8.
[AGENT][NEUTRAL] All right. What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII] and the middle name is [PII] and the last name is
[CUSTOMER][NEUTRAL] [PII]. and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. May I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII], the date of August, and the total charge amount is $3,045 even.
[AGENT][NEUTRAL] OK. Let me see if I got this right, and that was [PII] for $3,094.
[CUSTOMER][NEUTRAL] $3,045.
[AGENT][NEUTRAL] 340. I'm sorry.
[AGENT][NEUTRAL] All right, let me see if I can find this claim for you and for future, you can check claim status online through our website at [PII] and that's just optional. And bear with me. Let me see if I can find your claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Was this the facility charges or is it, um, you have procedure codes?
[CUSTOMER][NEUTRAL] Uh, it's uh anesthesia code 00731.
[AGENT][NEUTRAL] 00731 here we go. OK, let me pull this EV one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Yeah I'm waiting on the EOB to pull up.
[AGENT][NEUTRAL] OK, so it looks like we processed the claim on [PII] and the claim was denied. The reason for this denial is the outpatient benefits for the calendar year has been met.
[AGENT][NEGATIVE] The benefits have been exhausted.
[CUSTOMER][NEUTRAL] The benefits has been uh shorted.
[AGENT][NEUTRAL] Yes, the benefits has been exhausted.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The HR uh HRA and HSA plan.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Sorry, sir.
[CUSTOMER][NEUTRAL] Uh, so when did you receive this claim?
[AGENT][NEUTRAL] The claim was received. Let me see. Let me get that for you. That's not on the EOB um 6468 here we go, received on [PII].
[CUSTOMER][NEUTRAL] And then when it was denied?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So what we can do for this number now?
[AGENT][NEUTRAL] OK, so it was denied because she already assessed her benefits. So it's up to the provider's discretion um to continue with this claim, like what actions they're gonna do is up to the provider's discretion. We don't have any contractual enrollment on the remaining because we're just the secondary.
[CUSTOMER][NEUTRAL] Uh, is there, uh, OK.
[CUSTOMER][POSITIVE] Awesome
[CUSTOMER][NEUTRAL] OK, can you please provide me the claim number?
[AGENT][NEUTRAL] Sure, the claim number is 3556468.
[CUSTOMER][NEUTRAL] It's 3556468, is it correct?
[AGENT][NEUTRAL] Mhm. Yes, 3556468.
[CUSTOMER][NEUTRAL] And can you please send a copy of the UV for this number?
[AGENT][NEUTRAL] What is the fax number, Miss [PII]?
[CUSTOMER][NEUTRAL] It's [PII] consecutive [PII].
[AGENT][NEUTRAL] I'm sorry, can you repeat that one more time? 615?
[CUSTOMER][NEUTRAL] 3 consecutive 73536.
[AGENT][NEUTRAL] OK, so it's [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, to your attention, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, may I place you on hold while I send this out to you while I got you on the line.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for Miss [PII]. Yeah, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I have the question. Uh, so the claim denied for the maximum, uh, benefits met or it, or it is denied for the amount, um, maximum benefits?
[AGENT][NEUTRAL] It is OK, so this one has an outpatient maximum benefit of let's see.
[AGENT][NEUTRAL] Oh let's see 1000 per covered person per calendar year for outpatient service. By the time we receive this claim, she already met all her benefits, so she already used all her benefits.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So her, her total amount was 1000.
[AGENT][NEUTRAL] 1000 per person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The maximum amount was 1000, right?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] For the calendar year.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And uh can you please, uh can you please uh provide me the last uh service um date for this number?
[AGENT][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] We cannot release the information that is not pertaining to your claim. So based on your claim, that's the only information I can provide to you, which is that um the outpatient benefits for the calendar year has been exhausted for that date of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you please provide me the call reference number and can you please check another number too?
[AGENT][NEUTRAL] OK, we don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] OK. Can you please spell your name?
[AGENT][NEUTRAL] Sure, that's [PII]. That's initial [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just give me a second. I will provide you the next member ID.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So the next member ID is 02462268.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's uh the first name is [PII] and the last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] and the total bill amount is $237 a year.
[AGENT][NEUTRAL] Did you say [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, let me see if I can find this thing one moment.
[AGENT][NEUTRAL] OK, let me pull this EV one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, uh, like, uh, for the previous, uh, member, you said no, you can provide us the last date of service when the patient took the service.
[AGENT][NEUTRAL] Correct, yes. I, I can only give you information pertaining your claim. So I cannot release information about another provider to you.
[CUSTOMER][NEUTRAL] Is it right?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Um, let's see, so for this one, it looks like we received the claim on [PII], and we processed the claim on [PII], and the claim was denied. The denial reason for this one is that office visits are not covered by the policy.
[CUSTOMER][NEGATIVE] Of its visits are not covered by the policy, that's why it was denied for this number.
[AGENT][POSITIVE] Correct, yes. Mhm. Yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And not, it's not covered under the member's plan, OK?
[CUSTOMER][NEUTRAL] Oh, and it was denied on, um, [PII].
[AGENT][NEUTRAL] Yes, it was received and processed the same day, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] So it is also denied for the maximum benefits much, right?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] It's the nice stating that office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] So we can apply for this number?
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] Um, let's see, when was the first time that it was submitted. One moment.
[AGENT][NEUTRAL] OK, let me pull this out.
[AGENT][NEUTRAL] OK, so the original claim was processed, let's see.
[AGENT][NEUTRAL] Back in [PII], so [PII] was the original claim process and denied for the same reason, office visits is not covered under the member's plan, and you have 180 days from that decision date to submit any appeals.
[CUSTOMER][NEUTRAL] Uh, but in my system it shows, uh, shows that it was processed on [PII].
[AGENT][NEUTRAL] I'm sorry, can you repeat?
[CUSTOMER][NEUTRAL] You said that the original UB was processed on [PII]. And my system it shows the primary OV was processed on [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, we're not primary. I'm talking about our claims for our policy with with uh APL as a secondary.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the original claim, the first time the claim was submitted to us was on [PII], processed [PII], and the first time we decided that um the policy doesn't have any benefits for this member for office visits was [PII]. So from that day, you have 180 days to submit any appeals.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Correct. Mhm.
[CUSTOMER][NEUTRAL] The timely filing limit is uh
[CUSTOMER][NEUTRAL] 100 days, you said?
[AGENT][NEUTRAL] A
[AGENT][NEUTRAL] 180 days. The appealing address is uh uh time, I'm sorry, the appealing time frame is 180 days.
[CUSTOMER][NEUTRAL] OK. So uh for this number, we need to uh submit the bill only, right?
[AGENT][NEUTRAL] Again, you have 180 days from the decision date to submit any appeals.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you please tell me the fax number?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Sorry, you, your voice was talking. Can you please say it again?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you please tell me the mailing address sir?
[AGENT][NEUTRAL] Yeah, just to submit claims is [PII].
[AGENT][NEUTRAL] 950.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the, can you please tell me the claim number too?
[AGENT][NEUTRAL] Um, of the original one or the most recent one, which one would you like?
[CUSTOMER][NEUTRAL] For the appeal, uh, we have to send the recent one, right?
[AGENT][NEUTRAL] And for the appeal, you have to use the original one. The original one on the claim number is 352.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 7255.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you please send a copy of the UV for this number also?
[AGENT][NEUTRAL] OK. Do you mind holding for me while I send this out?
[CUSTOMER][NEUTRAL] Sorry, what did you say?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] I'm gonna put you on a brief hold so I can go ahead and send this one out as well, OK? One moment.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for Mr. OK, I went ahead and send that one as well. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] And can you please uh provide me the recent claim number too?
[AGENT][NEUTRAL] OK, um, bear with me. I'll have to go back to that one.
[CUSTOMER][NEUTRAL] And then can you please provide me the uh policy name too, as you said the claim denied and they don't cover the policy office visits.
[AGENT][NEUTRAL] This is a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] Sorry, uh, can you please say it again?
[AGENT][NEUTRAL] Secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] Yeah, did you say secondary supplemental plan to the major medical, right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes. Mhm. Secondary supplemental plan to the major medical. Yes, that is correct. OK. And uh um claim number for the original claim is 35 I'm sorry, for the most recent one. I already gave you the original. For the most recent one is 3556439.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And can you please uh provide me the call reference ma'am?
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's date.
[CUSTOMER][NEUTRAL] Sorry, I forgot.
[AGENT][NEUTRAL] It's OK.
[AGENT][NEUTRAL] Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yeah, can you, yeah, I have another number. Can you please check that?
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, go ah[PII] with the policy number.
[CUSTOMER][NEUTRAL] Drink some water and we can continue for it. I can wait for 2 minutes.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Sure, go ahead with the next one.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The next member ID is 016.
[CUSTOMER][NEUTRAL] 391-92 M as in M, L as in lion, 8.
[AGENT][NEUTRAL] Thank you. What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII] and the last name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, and what is the date of service for this member?
[CUSTOMER][NEUTRAL] It's [PII] and the total charge amount is $542 in.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment, let me pull this ERP.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] And we received the claim [PII] and we processed the claim on [PII].
[AGENT][NEUTRAL] And the claim was denied stating office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] Did you receive uh this claim [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, because in my system it shows, uh, we submitted electronically on [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, no, this is the only one I got. The only one I got is the one we received on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, can you please cross verify me the total bill amount on the date of service?
[AGENT][NEUTRAL] Mhm. Yup, let me go ahead and pull the details again.
[AGENT][NEUTRAL] It's $542 for procedure code 99204 Gastrohealth.
[CUSTOMER][NEUTRAL] Yeah. And the date of service is [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes, uh-huh.
[CUSTOMER][NEUTRAL] Yeah, but you will receive so long. Electronic, uh, things will be receiving one within the day.
[AGENT][NEUTRAL] Not sure.
[AGENT][NEGATIVE] I'm not sure why we received it so late. I don't know if it was just send it to us a different way or send again. I'm not sure that's just the day we received it on [PII].
[CUSTOMER][NEUTRAL] OK. And uh when the claim was denied?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] The claim denied for the maximum.
[AGENT][NEUTRAL] No, office, no, office visits are not covered by this policy.
[CUSTOMER][NEUTRAL] Visit
[CUSTOMER][NEUTRAL] Same like uh the last previous member?
[AGENT][NEUTRAL] Mhm. Yes. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Can you please tell me the claim number?
[AGENT][NEUTRAL] Yeah, sure. The claim number is 3569814.
[CUSTOMER][NEUTRAL] OK. And can you please uh provide me the policy name also?
[AGENT][NEUTRAL] It's the one it's a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] Same, uh, as you said the previous one.
[AGENT][NEUTRAL] Mhm. Yes, M. S.
[CUSTOMER][NEUTRAL] Secondary supplemental plan to the major medical, right?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you please uh send a copy of the UB for this number too?
[AGENT][NEUTRAL] Mm, OK, one moment.
[AGENT][NEUTRAL] It's gonna be a minute. I'm waiting on the system.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Gonna be one minute. I need to upload. That's why it takes a little bit long.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] It's OK, I can wait.
[AGENT][NEUTRAL] OK, I went ahead and send that one over.
[CUSTOMER][NEUTRAL] Did you send a copy of the UV?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you please check another number now?
[AGENT][NEUTRAL] That's the policy number?
[CUSTOMER][NEUTRAL] The policy number is 02549572 M as in Mike L as in Lion C.
[CUSTOMER][NEUTRAL] Sorry, 8, the last is 8, not 8.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 02549572. M as in Milk. L as in lion, and that last digit is 8.
[AGENT][NEUTRAL] OK. What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's the first name is [PII], the middle name is [PII], the last name is [PII], uh, and the
[CUSTOMER][NEUTRAL] Date of service is [PII]. The date, the date of birth, the date of service is [PII], and the total charge amount is $348 in.
[AGENT][NEUTRAL] And you said [PII] for the date of service?
[CUSTOMER][NEUTRAL] I said uh the date of services at number [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The total, sir.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah. And total bill amount is $348.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, we processed this one twice. I'm gonna give you the information of the original one because the last one was processed as a duplicate.
[AGENT][NEUTRAL] Um, so the original claim.
[CUSTOMER][NEUTRAL] But that's.
[AGENT][NEGATIVE] was received on [PII], processed [PII], and it was denied stating office visits are not covered by the policy.
[CUSTOMER][NEGATIVE] And it was uh received and denied on the same day?
[AGENT][NEUTRAL] No, it was received on [PII], processed [PII].
[CUSTOMER][NEUTRAL] And the recent claim is denied as a duplicate has been built twice, right?
[AGENT][NEGATIVE] Yeah, it was billed twice. So the most recent one was denied as a duplicate. The most recent one was received on [PII], processed [PII].
[CUSTOMER][NEUTRAL] OK. Can you please provide me the claim number?
[AGENT][NEUTRAL] The claim number for the original one or the duplicate?
[CUSTOMER][NEUTRAL] You can provide the both claim number.
[AGENT][NEUTRAL] OK. So the original claim number is 3540173.
[AGENT][NEUTRAL] And the duplicate is 3555923.
[CUSTOMER][NEUTRAL] OK. Can you please send a copy of the UV for this number and, and the policy name is the same?
[AGENT][NEUTRAL] Mhm. Yeah. Yeah.
[CUSTOMER][NEUTRAL] Secondary supplemental plan to the major Medicare.
[AGENT][NEUTRAL] To the major medical, yes.
[CUSTOMER][NEUTRAL] It's Medicare or medical?
[AGENT][NEUTRAL] Medical, to the major medical, not Medicare, it's medical.
[CUSTOMER][NEUTRAL] It's M E D I C A N, right?
[AGENT][NEUTRAL] It's M E D I C A L.
[CUSTOMER][NEUTRAL] Today?
[AGENT][NEUTRAL] M E D I C A L Medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let me put you on a brief hold while I send this fax. OK, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding. OK, I went ahead and send that over to you.
[CUSTOMER][NEUTRAL] OK. Can you please check the last name?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What is the patient's policy number?
[CUSTOMER][NEUTRAL] The policy number is 02295813 M as in M, L as in lion, and the last digit is 8. And the first name is [PII], the middle name is [PII] and the last name.
[AGENT][NEGATIVE] One moment, one moment, one moment, you're going too fast.
[AGENT][NEUTRAL] OK, what's the name and date of birth?
[CUSTOMER][NEUTRAL] So, it's [PII], the middle name is [PII], and the last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, what is the?
[CUSTOMER][NEUTRAL] And the date of services.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] and the total charge amount is $348 even.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so it looks like we received the claim on [PII].
[AGENT][NEUTRAL] And the claim was denied, office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] When it was denied.
[AGENT][NEUTRAL] Process on
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It was on [PII].
[AGENT][NEUTRAL] It's received on [PII], processed on the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And can you please provide me the claim number?
[AGENT][NEUTRAL] OK, that is 355-5902.
[CUSTOMER][NEUTRAL] OK. And the policy name is the same.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] And can you please send a copy of the UV for this number too?
[AGENT][NEUTRAL] OK. One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] it
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, I'll send that one as well.
[AGENT][NEUTRAL] Hello, Ms. [PII].
[CUSTOMER][POSITIVE] Yes, I'm there. Thank you for your assistance. Have a wonderful day and have a.
[AGENT][POSITIVE] You as well. Thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.