AccountId: 011433970860
ContactId: c936b523-54e1-4550-8320-8461ed447ecc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 772059 ms
Total Talk Time (AGENT): 105757 ms
Total Talk Time (CUSTOMER): 248914 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/c936b523-54e1-4550-8320-8461ed447ecc_20250430T21:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I'm calling from provider's office anesthesia service to check on general claim status. Could you please help me with this today?
[AGENT][POSITIVE] Yeah, I'm happy to check on a claim for you today. What's the policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, please stay on line. I'll just tell you the, the policy numbers patient's ID number, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, the patient's ID number?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] 01867080 ML 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient's name, uh, I just spell out his name, his last name is [PII]
[CUSTOMER][NEUTRAL] M [PII]
[CUSTOMER][NEUTRAL] Uh uh last first name of the patient is [PII] and first name is [PII].
[AGENT][NEUTRAL] Thank you. Date of birth?
[CUSTOMER][NEUTRAL] OK, date of birth of the patient is [PII].
[AGENT][NEUTRAL] Date of service.
[CUSTOMER][NEUTRAL] Uh, date of service of this claim is [PII].
[AGENT][NEUTRAL] And the bill amount?
[CUSTOMER][NEUTRAL] Uh, the total bill amount?
[CUSTOMER][NEUTRAL] 2000.
[CUSTOMER][NEUTRAL] $2000.86. 22086.
[AGENT][NEUTRAL] OK, give me just one moment.
[CUSTOMER][NEUTRAL] Maybe
[AGENT][NEUTRAL] Do you have an amount different after the primary paid?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Do you have an amount due after the primary paid different than the $2,086?
[CUSTOMER][NEUTRAL] Yes, I have. Uh, please stay on line. I'll just provide you.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK. The leftover balance here is
[CUSTOMER][NEUTRAL] 11097202022.
[AGENT][NEUTRAL] Repeat that one more time?
[CUSTOMER][NEUTRAL] 109722.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just one moment here while I check these claims.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you said that the provider was Boca Anesthesia Service, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So we have one claim on file date of service 11-27-04 um from Boca Anesthesia. The billed amount is 65052. It's not the 1,09722, so I don't have anything on file for that amount.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Actually,
[CUSTOMER][NEUTRAL] Uh, wait a moment. I just tell you.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Actually, previously, one of my colleague was worked on this account.
[CUSTOMER][NEUTRAL] And that rep said that the claim was processed and paid.
[AGENT][NEUTRAL] Do you have the claim number? Did they copy that down?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK. The claim number?
[CUSTOMER][NEUTRAL] Mm, uh, wait a minute, I just tell you the claim number.
[CUSTOMER][NEUTRAL] 243602-58408.
[AGENT][NEUTRAL] That's not our claim number.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But, uh,
[CUSTOMER][NEUTRAL] Mm, wait a minute, I'm just checking.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, please stay on line. I'll just tell you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Da da da.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, could you please check with uh call reference number?
[CUSTOMER][NEUTRAL] No, no, no, I'm asking to do, please check with the call reference number I have here.
[AGENT][NEUTRAL] You're just asking for a call reference?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] I can I can only check by a claim number. What's the call reference that you have?
[CUSTOMER][NEUTRAL] Um, the call reference that you have.
[CUSTOMER][NEUTRAL] Wait a minute, I'm just checking.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Actually, my portal is reflecting another amount. Can I tell that amount as well?
[AGENT][NEUTRAL] What's the amount that you have?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] The amount I have.
[CUSTOMER][NEUTRAL] It's $1,598.
[AGENT][NEUTRAL] OK, so claim is received on 4-21-25.
[CUSTOMER][NEUTRAL] OK. Uh, wait a minute. Uh, I'll just tell the details. uh please tell if this were correct or not.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] We received the claim.
[CUSTOMER][NEUTRAL] Uh, uh, actually I have some details in my system. I'm just pulling the details only. Please stay on line.
[CUSTOMER][NEUTRAL] Uh, please tell me, uh, when was the claim was received.
[AGENT][NEUTRAL] 42125.
[CUSTOMER][NEUTRAL] OK then processed.
[AGENT][NEUTRAL] 42125.
[CUSTOMER][NEUTRAL] OK. And the alert amount was 650, right?
[AGENT][NEUTRAL] $650.52.
[CUSTOMER][NEUTRAL] OK, there are no patient responsibility and they requested that you uh UB, but we did not receive UB still. Could you please share the UB for this because I have all the details in my system. I need a UB.
[AGENT][NEUTRAL] What's the
[AGENT][NEUTRAL] What's the fax?
[CUSTOMER][NEUTRAL] The facts I have, yeah.
[CUSTOMER][NEUTRAL] Sorry, my fax number is?
[CUSTOMER][NEUTRAL] 888
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] 350
[CUSTOMER][NEUTRAL] 5470.
[AGENT][NEUTRAL] Should we mark attention to anybody?
[CUSTOMER][NEUTRAL] Oh, it's my name, [PII].
[AGENT][NEUTRAL] OK, [PII], that'll be there in 5 minutes. Is there anything else I can do for you?
[CUSTOMER][NEUTRAL] No, please provide me the call reference number.
[AGENT][NEUTRAL] Call reference is my name with my last initial and today's date. My name again is [PII], that's [PII], and then today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh OK. Thank you so much, sir.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] You have a great day. Take care.