AccountId: 011433970860
ContactId: d5eb611e-a436-4baf-87f0-3cd0c30b1010
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 672770 ms
Total Talk Time (AGENT): 162861 ms
Total Talk Time (CUSTOMER): 115522 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/d5eb611e-a436-4baf-87f0-3cd0c30b1010_20250205T20:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling on behalf of provider's office checking for claim status.
[AGENT][NEUTRAL] I can assist you. Can you spell your first name for me?
[CUSTOMER][NEUTRAL] Sure. That is [PII]. And my initial is [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and you said you're checking claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] And the policy number is
[CUSTOMER][NEUTRAL] 02463466
[AGENT][NEUTRAL] And a phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] One moment please.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] All [PII]. Can you verify the patient's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] Yes, and the patient name is
[CUSTOMER][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Ro
[CUSTOMER][NEUTRAL] [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, and what's the date of service of the claim?
[CUSTOMER][NEUTRAL] And the date of service is [PII]. And the total bill amount is 10, sorry, that is $10,472 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And is this the hospital claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the claim was received [PII], processed [PII].
[CUSTOMER][NEUTRAL] Just a minute. Before that, can you please spell out your name for me?
[AGENT][NEUTRAL] It's [PII], first initial of my last name is [PII] and I was in the middle of giving you the claim status.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I get the claim status?
[AGENT][NEUTRAL] So the claim was received [PII].
[AGENT][NEUTRAL] Processed [PII].
[AGENT][NEUTRAL] Uh, the payment amount was $914.
[AGENT][NEUTRAL] And let me know when you're ready for the claim number.
[CUSTOMER][NEUTRAL] I'm ready for the claim number.
[AGENT][NEUTRAL] That number is 349.
[AGENT][NEUTRAL] 0906.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I get the denied status on the claim?
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] The claim was not denied. It was paid $914 was paid.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Just a minute.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] So the claim is not denied?
[AGENT][NEUTRAL] A payment of $914 was made.
[CUSTOMER][NEUTRAL] OK. Just a minute, please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Just a minute, I'm checking on it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you said that this is the facility charge, but this is actually the anesthesiologist charge. Is that correct?
[CUSTOMER][NEUTRAL] Yes. Yeah.
[AGENT][NEUTRAL] OK, so the claim number that I gave you is incorrect. It's not the hospital charges for the anesthesiologist and that claim number is 349.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 492 9.
[AGENT][NEUTRAL] And this claim did deny, we need a copy of the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The night for?
[AGENT][NEUTRAL] A copy of the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] After this.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And may I get the mailing address for this?
[AGENT][NEUTRAL] Mhm it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] City, [PII].
[CUSTOMER][NEUTRAL] Uh, can you please spell it?
[AGENT][NEUTRAL] OK, [PII]
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The state is [PII].
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And may I get the time, timely filing date?
[AGENT][NEUTRAL] There's no timely filing limit to submit the primary EOB.
[CUSTOMER][NEUTRAL] May I get the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] Uh, do you have fax number?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Patient effective and termination date?
[AGENT][NEUTRAL] OK, go ahead and give me all the information that you need.
[AGENT][NEUTRAL] So other than the effective date, what else do you need?
[CUSTOMER][NEUTRAL] Uh, that's it.
[AGENT][NEUTRAL] OK, the policy
[CUSTOMER][NEUTRAL] And the call reference number.
[AGENT][NEUTRAL] The policy effective date is [PII]. The policy termination date is [PII], and you'll use my name in today's date as reference for today's call.
[CUSTOMER][NEUTRAL] Uh, can you please spell out your name?
[AGENT][NEUTRAL] [PII], first initial last name is [PII].
[CUSTOMER][NEUTRAL] OK, and today's date, right?
[AGENT][NEUTRAL] My name in today's date.
[CUSTOMER][NEUTRAL] OK. [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL, Roma. Have a good day.
[CUSTOMER][NEUTRAL] This.
[CUSTOMER][POSITIVE] Have a good day.