AccountId: 011433970860
ContactId: c8589ff3-86e8-4a90-9eca-3537bda0cb27
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 611059 ms
Total Talk Time (AGENT): 165566 ms
Total Talk Time (CUSTOMER): 156322 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/c8589ff3-86e8-4a90-9eca-3537bda0cb27_20250619T16:23_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh hello?
[AGENT][NEUTRAL] Yes, hello, this is [PII] with APL. How may I assist you?
[CUSTOMER][NEUTRAL] Uh hello, good morning. My name is [PII] calling from Office urology surgeon of Oklahoma.
[AGENT][POSITIVE] Yes, and how may I assist you today?
[CUSTOMER][NEUTRAL] Uh, actually, I, uh, we have submitted one claim and I want to know the status of that claim. So can you help me out with that?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Sure, I can assist you with claims. May I have the spelling of your name?
[CUSTOMER][NEUTRAL] Yeah, it is [PII]
[AGENT][NEUTRAL] OK. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what's the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yeah, it is urology surgeon of Oklahoma.
[AGENT][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. It is 236-39009.
[AGENT][NEUTRAL] Thank you. What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, patient name is, uh, give me a moment.
[CUSTOMER][NEUTRAL] Yeah, patient name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Mm OK. Thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah, date of service is [PII].
[CUSTOMER][NEUTRAL] And give me a moment.
[CUSTOMER][NEUTRAL] Yeah. And the bill amount is $218.23.
[AGENT][NEUTRAL] Can you repeat the date of service one more time?
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[AGENT][NEUTRAL] OK, are you saying [PII] or you're saying [PII]?
[CUSTOMER][NEUTRAL] It is 1 [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you. OK, let me see if I can find this claim. For future, you can check claim status online through our website at [PII]. That's just optional.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. For that, we have to log in.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK one moment.
[AGENT][NEUTRAL] All right, let me look at this claim. One moment.
[AGENT][NEUTRAL] I'm still waiting.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, actually, we did this claim on uh [PII] because previously uh your colleague stated that the claim was not on file.
[AGENT][NEUTRAL] OK. Um, can you give me the procedure code of the claim?
[CUSTOMER][NEUTRAL] Yeah, it is 99213.
[AGENT][NEUTRAL] OK, and, and the claim is for $211.23.
[CUSTOMER][NEUTRAL] Mm, no, the total bill amount is $218.23.
[AGENT][NEUTRAL] One moment. I don't see that amount.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, I don't see one for that amount.
[AGENT][NEUTRAL] Do you wanna double check your information, make sure, because yeah, that amount is not matching to what I'm looking at and you're saying.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, Mr. [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, I'm here.
[AGENT][NEUTRAL] That amount because I don't find anything for $218.23.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So, uh, is there any, uh,
[CUSTOMER][NEUTRAL] Amount for date of service, [PII].
[AGENT][NEUTRAL] Yeah, I did find a claim, but that's not the amount and I need to give you the information of the claim you're calling about. If your claim is $218.23 then we don't have that claim on file.
[CUSTOMER][NEUTRAL] Give me a moment. Maybe I have a claim number. Let me check.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm mm mm. Give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm mm mm.
[CUSTOMER][NEUTRAL] No, we don't have that.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK, so more than that.
[CUSTOMER][NEUTRAL] OK. So you find the uh
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. Go on.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] OK, so you find the claim for $211.23.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, sir, can you provide me the status of that?
[AGENT][NEUTRAL] OK, yes, if you need a status on this one, I can give you this one, which is $211.23 and the claim was processed on [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And for the code 99213, uh, office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK, so it is uh because uh office is, is not covered under this policy.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Give me a moment, just.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. And can you tell me when this claim was denied?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, uh,
[CUSTOMER][NEUTRAL] And receive date of the claim.
[AGENT][NEUTRAL] OK, let me get the receipt date because that's not on the EOB. One moment.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] 9833.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] OK, so it was received on [PII], process [PII].
[CUSTOMER][NEUTRAL] And so the night it will be [PII], OK?
[AGENT][NEUTRAL] Correct. [PII] is the denial date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you provide me uh claim number?
[AGENT][NEUTRAL] Yes, that is claim number 3589833.
[CUSTOMER][NEUTRAL] 3589833.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you provide me call reference number for this call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's state if you will.
[CUSTOMER][NEUTRAL] OK. So, can you spell your name? Is it S [PII]?
[AGENT][NEUTRAL] It's [PII] last initial [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. So, thank you so much for your help and have a good day. Bye-bye.
[AGENT][POSITIVE] You as well and thank you for calling APL. Have a good day, Mr. [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah, bye bye.