AccountId: 011433970860
ContactId: d0c50c67-815a-4e2a-8af4-1aa21e642ce2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 765559 ms
Total Talk Time (AGENT): 179059 ms
Total Talk Time (CUSTOMER): 156389 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/d0c50c67-815a-4e2a-8af4-1aa21e642ce2_20250114T14:55_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. This is So. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my, my name is [PII] calling from provider's office. I'm checking on claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with current status, Mr. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it's 01792084.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] And can you please spell your name?
[AGENT][NEUTRAL] Sure. It's [PII].
[CUSTOMER][POSITIVE] Thank you so.
[AGENT][NEUTRAL] You're welcome. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Patient name is [PII].
[CUSTOMER][NEUTRAL] At that and date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Total charge is $2,296 even.
[AGENT][NEUTRAL] Thank you. OK. Let me see if I can find this claim for you. For future, you can check claim status online through our website at [PII] and that's just optional. And let me see if this is your claim. Do you have a procedure code?
[CUSTOMER][NEUTRAL] Yes, it's to procedure code.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 963-72 and 3145.
[AGENT][POSITIVE] All right. Thank you.
[AGENT][NEUTRAL] OK, it's gonna be a minute. I'm waiting on destination and benefits.
[CUSTOMER][NEUTRAL] And I have a specific question on this claim.
[AGENT][NEUTRAL] OK, I'm still waiting on the air.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so we process the claim [PII].
[CUSTOMER][NEUTRAL] OK, so we
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And we send $1,571.99.
[CUSTOMER][NEUTRAL] And it was recouped again.
[CUSTOMER][NEUTRAL] So may I know the reason for the recoupment?
[CUSTOMER][NEUTRAL] While it was recouped.
[AGENT][NEGATIVE] What is the recoup and what is um why you think it's recoup what's not understanding you.
[AGENT][NEUTRAL] Can you explain?
[CUSTOMER][NEUTRAL] Because uh the payment was.
[CUSTOMER][NEGATIVE] Um, got to return.
[CUSTOMER][NEGATIVE] There is no payment. It was recouped. It was taken back which you initially got paid.
[CUSTOMER][NEUTRAL] And it was taken back.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEGATIVE] It was not taken back. It was reissued because it was voided and reissued, and that is the reissued. This is the last one we sent out.
[CUSTOMER][NEUTRAL] Taking back it was reissued because.
[CUSTOMER][NEUTRAL] and that.
[CUSTOMER][NEUTRAL] OK, so may I know the process date when it was processed, you said this September?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a second, let me pull the information one more time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so it was reissued on [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I have the claim number?
[AGENT][NEUTRAL] Yes, 351-0669.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, and may I know the mode of payment?
[AGENT][NEUTRAL] It's a check, single check, paper check?
[CUSTOMER][NEUTRAL] May I have the allowed amount for this claim?
[AGENT][NEUTRAL] Let me check the primary EOB because we don't do a lot of amount that's based on the primary EOB.
[AGENT][NEUTRAL] One moment, we are the secondary.
[CUSTOMER][NEUTRAL] It was secondary or primary?
[AGENT][NEUTRAL] We are the secondary.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Based on the
[CUSTOMER][NEUTRAL] Oh my.
[AGENT][NEUTRAL] Major medical.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] The lot amount was $1,571.99.
[AGENT][NEUTRAL] Which is what we sent.
[CUSTOMER][NEUTRAL] $1,577 right?
[AGENT][NEUTRAL] $71.99.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And uh can I have the check number?
[AGENT][NEUTRAL] Sure, the check number is 2004865.
[CUSTOMER][NEUTRAL] And uh the check was issued on the same date, right? [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And uh can I have the pay to address?
[CUSTOMER][NEUTRAL] Now which address the check was issued?
[AGENT][NEUTRAL] Yes, it was sent to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. May I know the, the cash was cash, um, the check was cash or still in process?
[AGENT][POSITIVE] It's still showing outstanding.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And can you send the UB through fax?
[CUSTOMER][NEUTRAL] For
[AGENT][NEUTRAL] OK, what is the fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] I'll mention my name in uh attention, [PII].
[AGENT][NEUTRAL] OK. Do you mind holding for me while I send this out to you while I got you on the line, Mr. [PII]?
[CUSTOMER][NEUTRAL] In
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me Mr. [PII]. Yeah, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK. Can I have the call reference number?
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK. Thank you so much for asking today. Have a great day. Take care. Bye-bye.
[AGENT][POSITIVE] You as well thank you for calling APM. Bye-bye.