AccountId: 011433970860
ContactId: d47ca8a2-2ce3-4759-85c7-eb2884ba2cf8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 267760 ms
Total Talk Time (AGENT): 107309 ms
Total Talk Time (CUSTOMER): 79978 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/d47ca8a2-2ce3-4759-85c7-eb2884ba2cf8_20250211T14:22_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm from Fast Track Physical Therapy, checking on 3 different data services for 1 number. I'm checking claim status.
[AGENT][NEUTRAL] OK, what's the policy number?
[CUSTOMER][NEUTRAL] 02514977 M as in mom L as in Lima 7.
[AGENT][NEUTRAL] And your phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Area code [PII], and that's my direct line.
[AGENT][NEUTRAL] OK, what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you for that information and we're checking 3 claim statuses.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Can you give me the dates of service and charge for each of those.
[CUSTOMER][NEUTRAL] The first one, [PII], bills amount $334.
[AGENT][NEUTRAL] OK, the next one.
[CUSTOMER][NEUTRAL] [PII] bills amount $334.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And the last 1 [PII] billed amount 324.
[AGENT][POSITIVE] Thank you and you said this is for physical therapy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me pull up her file and then we can verify the information.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, starting with date of service [PII].
[AGENT][NEUTRAL] This claim was processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, showing a payment amount of $75 that would be for the $97,140 procedure code. Uh, the other codes on this claim.
[AGENT][NEUTRAL] Says that benefits are payable only if your major medical insurance provider provides benefits. Um, if this claim is later paid by your by the major medical insurance, please send the explanation of benefits showing where the benefits were paid. So those other three codes were denied by the primary on this claim.
[CUSTOMER][NEUTRAL] I'm sorry, the, the, the other three what?
[AGENT][NEUTRAL] Procedure codes on the claim?
[CUSTOMER][NEUTRAL] Oh, OK. Um, do you have a check number of this particular check of $75?
[AGENT][NEUTRAL] Check number
[AGENT][NEUTRAL] Mhm. 202-2564.
[CUSTOMER][NEUTRAL] OK, and date of service [PII]?
[AGENT][NEUTRAL] Mhm, moving to the next date of service.
[AGENT][NEUTRAL] Processed on the [PII] as well.
[AGENT][NEUTRAL] Issuing a payment for procedure code 97,140 of $75 check number.
[AGENT][NEUTRAL] 2022.
[AGENT][NEUTRAL] 565.
[AGENT][NEUTRAL] And for data service 1219.
[AGENT][NEUTRAL] Processed on the [PII] as well, $75 payment for procedure 97,110.
[AGENT][NEUTRAL] Check number 2022562 and do you want the claim numbers for each, Margaret?
[CUSTOMER][NEUTRAL] No thank you. No, I don't need the claim numbers. Can I have a reference for, uh, I'm sorry, a reference number for this call, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's OK.
[AGENT][NEUTRAL] So you'll use my name in today's date as your reference, [PII] First initial of last name is [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you so much. You have a great day.
[AGENT][POSITIVE] Oh, you're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.