AccountId: 011433970860
ContactId: ab1d97bf-295a-48c1-8b5d-ea1adb670922
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 497890 ms
Total Talk Time (AGENT): 215511 ms
Total Talk Time (CUSTOMER): 171346 ms
Interruptions: 4
Overall Sentiment: AGENT=1.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/ab1d97bf-295a-48c1-8b5d-ea1adb670922_20250402T15:24_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi I was calling uh regarding a patient with us. I needed an update on their claim.
[AGENT][POSITIVE] Well, it would be my pleasure to help you with claim status. May I ask your name?
[CUSTOMER][NEUTRAL] It's [PII], last initial [PII]
[AGENT][POSITIVE] Thank you, [PII]. And what is a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, it is 02415539.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] All right, thank you. [PII].
[CUSTOMER][NEUTRAL] Or [PII], sorry, yeah, there you go.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Yeah, it was like [PII], sorry.
[AGENT][POSITIVE] Not a problem. I can help you with that claim status. That sounds like something I would do. What is, what is?
[CUSTOMER][NEUTRAL] I'm not fully awake after [PII].
[AGENT][POSITIVE] You know, I, I really need another cup of coffee myself, so I get it.
[AGENT][NEUTRAL] What is that date of service, please?
[CUSTOMER][NEUTRAL] Um, I have, I think, two of them. Um, first one is going to be [PII].
[AGENT][NEUTRAL] Thank you, what is the facility name, please?
[CUSTOMER][NEUTRAL] TMI sports medicine.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, it looks like we did receive that claim on [PII].
[AGENT][NEUTRAL] Processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that claim number is 349.
[AGENT][NEUTRAL] 2280.
[AGENT][NEGATIVE] Now this one was denied because benefits are only payable if the primary insurance provides benefits.
[AGENT][NEUTRAL] And according to the EOB we've received.
[CUSTOMER][NEUTRAL] And they did.
[AGENT][NEUTRAL] According to the one.
[AGENT][NEUTRAL] That we received.
[AGENT][NEUTRAL] It did not have a copay, deductible or co-insurance applied. Now you can fax, if you've got that updated EOB, you can fax that to our claims department and I can give you a policy number and claim number to refer to.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] Uh, well, I have already given you the claim number 3,492,280. You gave me the policy number, so you've got that information, but you can fax that directly to our claims department at 877.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, and can I get an update on the other one I have as well?
[AGENT][NEUTRAL] Absolutely what's that data service.
[CUSTOMER][NEUTRAL] Uh, 6-18-2024 it looks like he's just sitting there.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] What was that bill amount?
[CUSTOMER][NEUTRAL] Um, to you guys, let me go back.
[AGENT][NEUTRAL] Just a total bill amount.
[CUSTOMER][NEUTRAL] Um, in total it's 200.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] OK, so that one we received on [PII] also.
[AGENT][POSITIVE] Processed on [PII] and paid, let me get that paid out for you.
[AGENT][NEUTRAL] $140.79 to TMI sports medicine.
[CUSTOMER][NEUTRAL] Hm, OK.
[CUSTOMER][NEGATIVE] I don't know why it's issue tracker.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and then last one.
[CUSTOMER][NEUTRAL] Um, data service is 6-25-2024.
[AGENT][NEUTRAL] Do you want that, um.
[AGENT][NEUTRAL] 618 data service claim number.
[CUSTOMER][NEUTRAL] Yeah, let me get that one too. It looks like it's on hold still.
[AGENT][NEUTRAL] Yeah, it was processed on [PII]. That claim number is 349.
[AGENT][NEUTRAL] 227-9 and I can provide that check number if you need that as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Check number is 186.
[AGENT][NEUTRAL] 796.
[AGENT][NEUTRAL] I'm sorry, 7976. I told you I need that other cup of coffee.
[CUSTOMER][NEUTRAL] 7.
[CUSTOMER][NEUTRAL] We're in the same boat, OK, and uh that's with that one, OK.
[AGENT][NEUTRAL] OK, now let me check. 6:25.
[CUSTOMER][NEUTRAL] And this is for her.
[AGENT][NEUTRAL] The 6:25.
[AGENT][NEUTRAL] We received that one on [PII] and processed on [PII] and paid 19803.
[CUSTOMER][NEUTRAL] Hm 1625.
[CUSTOMER][NEUTRAL] OK, I don't see a payment at all. I only see.
[CUSTOMER][NEGATIVE] That it got billed to you guys only $40.
[CUSTOMER][NEUTRAL] And then I got transferred over to the patient, um.
[AGENT][NEUTRAL] And that was for the 971-619-75380 CPT?
[CUSTOMER][NEUTRAL] Let me double check.
[CUSTOMER][NEUTRAL] Secondary.
[CUSTOMER][NEUTRAL] Covered apparently called American D.
[CUSTOMER][NEGATIVE] Might be different because it looks like they called and spoke with somebody of Eva AVI and then I denied it.
[AGENT][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And that was for 62524?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Yeah, I said it was denied and I still don't have it got transferred over to the patient. I don't see a payment at all for that one.
[AGENT][NEUTRAL] I see that the check cleared.
[CUSTOMER][NEUTRAL] OK, let me, I guess I have to look a little bit more on that 1 625 and what was the amount that you guys pay for that one?
[AGENT][NEUTRAL] I can give you that claim number and check number. Yeah, 19803.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, you know what, there was another one for the data service of 625 just for the office visit. I mean when EB told her about the one.
[CUSTOMER][NEUTRAL] And then what was the number?
[AGENT][NEUTRAL] We had another claim for 6:25 for the visit.
[CUSTOMER][POSITIVE] OK, yeah, you're right, I see the one.
[AGENT][NEUTRAL] That's what that was.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But for the 9716.
[CUSTOMER][NEUTRAL] OK, you guys don't do the offices.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, alright, that's the one I was looking for. OK, I didn't see that one right above it, OK.
[AGENT][NEUTRAL] Never mind, sorry.
[CUSTOMER][NEUTRAL] All right, I'll look on to the other ones. No, it's OK, um.
[CUSTOMER][NEUTRAL] I will double check on that um.
[CUSTOMER][NEUTRAL] [PII] and if anything I'll give you guys a call back.
[AGENT][POSITIVE] Yeah, it, that'd be fine. We'll be happy to help you any way we can.
[CUSTOMER][POSITIVE] OK awesome thank you so much for your help.
[AGENT][POSITIVE] It's been my pleasure to assist you with that claim status, [PII]. Anything else I can help you with?
[CUSTOMER][NEUTRAL] Um, just your name, please.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect thank you so much [PII] for your help.
[AGENT][POSITIVE] Oh, it's been my pleasure and thank you for calling APL Care. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.