AccountId: 011433970860
ContactId: d55a2192-459e-4a7b-88c9-ff2fa95f8d27
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 598229 ms
Total Talk Time (AGENT): 150406 ms
Total Talk Time (CUSTOMER): 227443 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/d55a2192-459e-4a7b-88c9-ff2fa95f8d27_20250221T19:31_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office, checking on claims.
[AGENT][POSITIVE] I'd be happy to assist with claims today still if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] And the policy number is 02253357.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the patient's last name is uh [PII]. It's uh [PII], again, [PII].
[AGENT][NEUTRAL] I'm sorry, what was the date of birth?
[CUSTOMER][NEUTRAL] The patient's date of birth is [PII].
[AGENT][NEUTRAL] What's the date of service for the claim?
[CUSTOMER][NEUTRAL] The data service is [PII] and bill amount is $250 even.
[AGENT][NEUTRAL] OK, thank you for that information. I'm not showing we have that claim on file.
[CUSTOMER][NEUTRAL] 00, just give me a second, ma'am. My just my system was hanged here.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Oh, thanks for being on line. Could you spell your name for my documentation?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Oh, that's nice.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, may I know the point, uh, that's nice. OK. May I know the policy effective dates of the patients?
[AGENT][NEUTRAL] Effective date is.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the policy is still active.
[CUSTOMER][NEUTRAL] Uh, may I know the payer ID to submit the claim?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Uh, may I know the mailing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] It's [PII]. Am I right?
[AGENT][NEUTRAL] No, zip code is [PII].
[CUSTOMER][POSITIVE] 073124. OK, that's nice. Thanks for that. And I do have the fax number for submitting the claim.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. Am I right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, and uh can I get the call reference number for this patient?
[AGENT][NEUTRAL] Reference is just my name [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] OK, just give me a second. Uh, yeah, I do have one more claim for the same patient. Could you help me with that?
[AGENT][NEUTRAL] Data service?
[CUSTOMER][NEUTRAL] Yeah, just give me a second, ma'am, just I need to pull up the data.
[CUSTOMER][NEUTRAL] The date of service is uh [PII].
[AGENT][NEUTRAL] And your tax ID?
[CUSTOMER][NEUTRAL] The tax ID is
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm showing a payment was made in the amount of $50 on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Uh, just give me a second, ma'am. Sorry for that.
[CUSTOMER][NEUTRAL] Um, may I know when was the claim received?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, when was the claim received, ma'am?
[AGENT][NEUTRAL] Oh, claim was received on [PII].
[CUSTOMER][NEUTRAL] [PII] process on?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, may I know the claim number for that?
[AGENT][NEUTRAL] Claim number is 3551752.
[CUSTOMER][NEUTRAL] 3551752. Am I right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, what was the allowed amount?
[AGENT][NEUTRAL] Um, we don't do a loud amounts, um.
[AGENT][NEUTRAL] The benefit amount that was paid, we paid $50 and that was the remaining benefit they had for their outpatient.
[CUSTOMER][NEUTRAL] Uh, what is the pay amount?
[CUSTOMER][NEUTRAL] Uh, may I know what type of patients responsibility?
[AGENT][NEUTRAL] Um, we don't determine patient responsibility.
[CUSTOMER][NEUTRAL] Uh, you just pay the paid amount is $50 right?
[AGENT][NEUTRAL] Yes, we paid $50.
[CUSTOMER][NEGATIVE] And there is no patients responsibility, right?
[AGENT][NEUTRAL] Well, uh, we don't determine that if, you know, we, we're, we're only the supplemental we don't determine.
[CUSTOMER][NEUTRAL] OK, sorry for that. Uh, may I know the
[CUSTOMER][NEUTRAL] OK, uh, may I know the, uh, payment mode? What type of payment mode it's made to check or the EFT?
[AGENT][NEUTRAL] Um, it was a check.
[CUSTOMER][NEUTRAL] Oh, you, may I know the check number?
[AGENT][NEUTRAL] 202-3049
[CUSTOMER][NEUTRAL] 202-3049. Am I right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, it is a bulk check or paper single check?
[AGENT][NEUTRAL] Single.
[CUSTOMER][NEUTRAL] Single, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, may I know the pay to address?
[AGENT][NEUTRAL] It went to Gastro Health [PII].
[AGENT][NEUTRAL] 9, excuse me, oh no, I'm sorry, [PII].
[CUSTOMER][NEUTRAL] If
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, a main order, uh.
[CUSTOMER][NEUTRAL] Just give me a second, ma'am.
[CUSTOMER][NEUTRAL] Uh, do you have any bank account details, ma'am?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, may I know that, uh, on which account the amount of Clay, uh, want to pay do you.
[AGENT][NEGATIVE] I don't understand the question.
[CUSTOMER][NEUTRAL] Uh, do you have the, uh, account details for the provider?
[CUSTOMER][NEUTRAL] On which account the cash was uh.
[AGENT][NEUTRAL] I don't know. You, you would have to contact Gastro Health billing department. They cashed the check on [PII], but I don't know what account they they did it in.
[CUSTOMER][NEUTRAL] Made.
[AGENT][NEUTRAL] You would need to contact them for that.
[CUSTOMER][NEUTRAL] Uh, could you repeat that cash date, ma'am?
[AGENT][NEUTRAL] Check was cashed on [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, thanks for that. And the call reference number is same, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Uh, uh, my, uh.
[CUSTOMER][NEUTRAL] Uh, can you fax that it will be.
[AGENT][NEUTRAL] What's the fax number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 6, sorry, [PII].
[AGENT][NEUTRAL] To whose attention?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][POSITIVE] Alright, you should receive that you'll be by close of business today. Was there anything else I could assist with today?
[CUSTOMER][POSITIVE] No, ma'am. Thanks for that. You said uh very soon that you will be end of the day, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] Yeah, thank you so much, ma'am. Thank you so much for assisting me. Have a nice day. Bye-bye.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye bye.