AccountId: 011433970860
ContactId: ac72284b-ee8f-4460-9428-0193002b4e26
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 545880 ms
Total Talk Time (AGENT): 123915 ms
Total Talk Time (CUSTOMER): 182520 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/ac72284b-ee8f-4460-9428-0193002b4e26_20250619T13:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, this is [PII] calling from our provider's office to check a claim status.
[AGENT][NEUTRAL] Hi, I'm happy to check on a claim. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Can you please talk with the louder? I can't hear for your voice.
[AGENT][NEUTRAL] Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, the patient policy number is 02515816.
[AGENT][POSITIVE] Thank you. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, the callback number is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient, the patient's first name is [PII] and the last name is [PII].
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][POSITIVE] Thank you. Data service?
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII] and the total bill amount is $492.96.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] G
[AGENT][NEUTRAL] Thank you for your patience. I show that we received this claim on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, one second.
[CUSTOMER][NEUTRAL] Yeah, can you please say for when the claim was received?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and the process date?
[AGENT][NEUTRAL] Same date, [PII].
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] There was a benefit payment sent in the amount of $75.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah, the, uh, the claim was sent for benefits team.
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] Yeah, the claim was sent to a benefits plan.
[AGENT][NEUTRAL] It was sent through a benefits plan. I'm sorry, I don't understand what your question is.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, how much it is paid?
[AGENT][NEUTRAL] $75.
[CUSTOMER][NEUTRAL] Yeah, OK. And uh what is the allowed amount?
[AGENT][NEUTRAL] That was the maximum benefit for the date of service.
[CUSTOMER][NEUTRAL] Mm, can you please say for how much is?
[AGENT][NEUTRAL] $75 is the max benefit.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] And that is a lot much?
[AGENT][NEUTRAL] Yes, that's the max amount.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and uh what is the patient responsibility?
[AGENT][NEUTRAL] We're not able to advise on patient responsibility that's up to the facility or the provider.
[CUSTOMER][NEUTRAL] Yeah, OK. And uh
[CUSTOMER][NEUTRAL] Can you please uh say for that?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] Uh, yeah, yeah, uh, I've seen for here, uh, that is, uh, the claim was denied with uh 00119.
[CUSTOMER][NEUTRAL] Uh, what is that reason for that for denied?
[AGENT][NEUTRAL] I don't see 0119 procedure code.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] No, only CO1199 is there, that is, and that's gonna be uh the procedure code 8 8788811 and J1100.
[CUSTOMER][NEUTRAL] And also
[CUSTOMER][NEUTRAL] 963-72 uh the three CPT codes are denied.
[AGENT][NEUTRAL] Right, because the maximum benefit had already been paid, so there was nothing additional to pay.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] That.
[AGENT][NEUTRAL] Was there any additional information I could assist with today?
[CUSTOMER][NEUTRAL] Yeah, and you can you please, uh, the remaining balance are responsible for that patient.
[AGENT][NEUTRAL] Again, we cannot advise on patient responsibility that's up to the facility or the provider.
[CUSTOMER][NEUTRAL] Yeah, OK. And uh
[CUSTOMER][NEUTRAL] Can you please uh say for that how it is paid, uh, check or EFT?
[AGENT][NEUTRAL] Single check.
[CUSTOMER][NEUTRAL] And uh can you please say for that check uh number?
[AGENT][NEUTRAL] 202-3692
[CUSTOMER][NEUTRAL] Yeah, that is 202-3692. Is it correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah, and uh
[CUSTOMER][NEUTRAL] Can you please say for that uh it is uh when the issue and uh when the clear for that check.
[AGENT][NEUTRAL] I don't have a clear date. The check was issued on [PII].
[CUSTOMER][NEUTRAL] And uh that is that gonna be uh processed date.
[AGENT][NEUTRAL] Right, that was the process date. I don't have a cache date.
[CUSTOMER][NEUTRAL] Yeah, and
[CUSTOMER][NEUTRAL] Yeah, OK. And can you please say for the claim number?
[AGENT][NEUTRAL] 35536.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 12.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And your name?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And uh.
[CUSTOMER][NEUTRAL] Yeah, and, uh, can, can you say for that, uh, can you send me the fax copy of UP through the through a fax.
[AGENT][NEUTRAL] What's the fax number?
[CUSTOMER][NEUTRAL] Yeah, the fax number is gonna be.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Attention to anybody?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Give it about 5 minutes and you should have it, OK?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, OK, can you please, uh, hold on one second.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Can you please, uh, say for that call reference number?
[AGENT][NEUTRAL] Call references my name with today's date.
[CUSTOMER][NEUTRAL] Yeah, and your last name and first initial is?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, OK, and uh.
[CUSTOMER][POSITIVE] Thank you so much [PII] to assist me.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] Have a great day.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] OK, thank you.