AccountId: 011433970860
ContactId: c653ae57-a9b6-4217-b8b2-c474226541f8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 343869 ms
Total Talk Time (AGENT): 99050 ms
Total Talk Time (CUSTOMER): 138190 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.4, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/c653ae57-a9b6-4217-b8b2-c474226541f8_20250613T15:28_UTC.wav
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[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] Can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. This is [PII]. My last initial [PII] for Bravo. I'm calling for claim status.
[AGENT][NEUTRAL] OK, I can verify claim status for you, [PII]. And what is the policy number, please?
[CUSTOMER][NEUTRAL] Callback number [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] you can reach me directly?
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][NEUTRAL] The policy number policy number is 021.
[CUSTOMER][NEUTRAL] 235-559
[AGENT][NEUTRAL] OK, thank you. Hold on one moment, please.
[AGENT][NEUTRAL] OK. And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Patient first name, [PII]. Last name [PII] And uh date of birth, [PII].
[AGENT][NEUTRAL] OK, uh, thank you. And what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the total charge is $661 even that is 661.
[AGENT][NEUTRAL] And the balance after primary has processed the claim?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, the balance amount is 200, 1 moment.
[CUSTOMER][NEUTRAL] The balance amount is $276.89. It was uh it was submitted one moment, yes.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It was submitted on [PII]. It was denied as duplicate, so I want to know the original claim status.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] And the name of the provider's office?
[CUSTOMER][NEUTRAL] Stuart Oncology Associate and the individual individual provider name is [PII].
[AGENT][NEUTRAL] Or
[AGENT][NEUTRAL] OK one moment.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Uh, it looks like the claim process is the benefits were applied towards the outpatient deductible.
[AGENT][NEUTRAL] Of $500.
[CUSTOMER][NEUTRAL] Mhm and the original claim was received on process.
[AGENT][NEUTRAL] Um me one moment.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, um, so the claim was originally received on [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[CUSTOMER][NEUTRAL] OK. And the co-insurance amount $276.89 is applied to us members deductible.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Can I have the annual deductible amount for this number?
[AGENT][NEUTRAL] Uh, the patient has a $500 deductible.
[CUSTOMER][NEUTRAL] $500. What is the current, uh, what is the current amount?
[AGENT][NEGATIVE] Well it still hasn't at the time of service, they still hadn't met their deductible amount, so.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] They still haven't finish up their deductible for the year.
[CUSTOMER][NEUTRAL] I still
[CUSTOMER][NEUTRAL] OK, still, uh, they have a $500 even, right?
[AGENT][NEGATIVE] No, they still had not met their $500 deductible.
[CUSTOMER][NEUTRAL] OK, OK, OK, thank you. And can I have the claim number?
[AGENT][NEUTRAL] Uh, 359-422-22.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 359-43 consecutive 2 right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, thank you. And could you send the copy of EOB to our fax number?
[AGENT][NEUTRAL] Sure, what is the fax number?
[CUSTOMER][NEUTRAL] Or a mailing address, yes, our fax number [PII]. Attention to my first name [PII].
[AGENT][NEUTRAL] OK, and then just verify, you said [PII]. Is that correct?
[CUSTOMER][POSITIVE] Mhm, yes, that's correct.
[AGENT][NEUTRAL] OK, and is there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] Uh, nothing else. Thank you so much. And before, could you spell your name?
[AGENT][NEUTRAL] [PII], and you may use my name in today's date as reference.
[CUSTOMER][POSITIVE] Mhm. OK, thank you, thank you so much. I also turn out on time to receive the EOB.
[AGENT][POSITIVE] You're welcome thanks for calling APL.
[AGENT][NEUTRAL] Uh, hopefully in a few moments.
[CUSTOMER][POSITIVE] Mhm. OK, thank you, thank you so much. Have a nice day take care bye bye. Happy weekend.
[AGENT][NEUTRAL] You too, bye.