AccountId: 011433970860
ContactId: da23ff5a-b5fd-47bc-aea6-6b5b31ceba5b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 707229 ms
Total Talk Time (AGENT): 297669 ms
Total Talk Time (CUSTOMER): 127582 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/da23ff5a-b5fd-47bc-aea6-6b5b31ceba5b_20250110T16:11_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office. proceeding, I would like to share this call is recorded for training and quality purpose. Is it OK for you?
[AGENT][NEUTRAL] Yes, that would be fine, and I apologize I missed your name. What is your name?
[CUSTOMER][NEUTRAL] [PII]. It's spelled out [PII]
[AGENT][POSITIVE] Thank you [PII], and what is a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you for calling.
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][POSITIVE] Yeah, you're welcome.
[CUSTOMER][NEUTRAL] Uh, before that, can you spell out your name for me, please?
[AGENT][NEUTRAL] Sure, my name is [PII].
[CUSTOMER][POSITIVE] Thank you, [PII]. Uh, member I would be, yeah.
[AGENT][POSITIVE] My pleasure.
[CUSTOMER][NEUTRAL] Member ID would be 01947059 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the name of the patient and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you, and it would be my pleasure to assist you today. How can I help you with [PII]?
[CUSTOMER][NEUTRAL] Claim status.
[AGENT][NEUTRAL] Alright, I can help you with that claim status. What is the data service?
[CUSTOMER][NEUTRAL] For data service.
[CUSTOMER][NEUTRAL] [PII], with total charge of $375 even.
[AGENT][POSITIVE] All right, thank you. Now [PII].
[AGENT][NEUTRAL] The policy that you gave me is no longer active as of [PII]. I'm checking to see if she had active coverage for that data service, if you don't mind holding one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, for [PII], she does did have active coverage for that data service. I can provide you with that policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For that data service, the correct policy number is 22 I'm 2267918.
[CUSTOMER][NEUTRAL] 226-791-8, right?
[AGENT][NEUTRAL] That's correct. And you said the correct, uh, the bill amount was 375?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm checking, bear with me just one moment.
[AGENT][NEUTRAL] Is that for CPT 77,080?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the facility name?
[CUSTOMER][NEUTRAL] Vital MD Group Holding.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Could it be under another billing provider name?
[AGENT][NEUTRAL] Like the facility name?
[CUSTOMER][NEUTRAL] Yeah. It will be diagnostic Center of Miami.
[AGENT][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] Looks like we received that claim 3 times. The original claim we received, it was pending for the primary EOB.
[AGENT][NEUTRAL] We did receive that primary EOB on [PII].
[AGENT][NEUTRAL] And processed and paid the claim on [PII].
[AGENT][NEUTRAL] In the amount of $283.92.
[AGENT][NEUTRAL] And that payment did go to diagnostic Center of Miami. It's a single paper check.
[CUSTOMER][NEUTRAL] Just a
[CUSTOMER][NEUTRAL] Can you provide me the check number?
[AGENT][NEUTRAL] Check number 2015305.
[CUSTOMER][NEUTRAL] Claim number.
[AGENT][NEUTRAL] Claim number is 353.
[AGENT][NEUTRAL] 367 0
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] It's been a pleasure to assist you with that claim status [PII]. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Yes, actually, I have 2 more clients with the same date of service.
[AGENT][NEUTRAL] Is it for the same patient?
[CUSTOMER][NEUTRAL] Yes, for the same date of service.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Bear with me just one second. Let me get back to that.
[AGENT][NEUTRAL] And that date of service was [PII] and what is the billed amount?
[CUSTOMER][NEUTRAL] $850 even.
[AGENT][NEUTRAL] Is that with the multiple.
[AGENT][NEUTRAL] CPTs or is it just one CPT?
[CUSTOMER][NEUTRAL] Multiple procedure codes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Same facility?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm checking, bear with me.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And we received that claim several times as well, um, original claim request in the primary EOB we received that EOB on [PII].
[AGENT][NEUTRAL] And processed and paid on [PII].
[AGENT][NEUTRAL] In the amount of.
[AGENT][NEUTRAL] $509.92 to diagnostic Center of Miami.
[CUSTOMER][NEUTRAL] OK, confirm the check number.
[AGENT][NEUTRAL] Check number 2015303.
[CUSTOMER][NEUTRAL] OK. When was that?
[AGENT][NEUTRAL] On [PII], single paper check.
[CUSTOMER][NEUTRAL] When was issued?
[AGENT][NEUTRAL] 11:22.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You want the claim number?
[CUSTOMER][NEUTRAL] Next date of service. Yes, sir.
[AGENT][NEUTRAL] 353.
[AGENT][NEUTRAL] 3666. And did I give you that other claim number, the previous claim number?
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, alright, just wanna make sure and what's that next date of service?
[CUSTOMER][NEUTRAL] Uh, same rate of service, total charge. It's $500 even.
[AGENT][NEUTRAL] Is that for CPT 76641?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm getting that information.
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] That claim was received on [PII], processed and paid on [PII] and the amount of $383.30 to my diagnostic Center in [PII].
[AGENT][NEUTRAL] Single paper check.
[AGENT][NEUTRAL] And that check number.
[AGENT][NEUTRAL] Is 201.
[AGENT][NEUTRAL] 5306
[CUSTOMER][NEUTRAL] Claim number.
[AGENT][NEUTRAL] Claim number 353.
[AGENT][NEUTRAL] 367 8
[CUSTOMER][NEUTRAL] OK. Thank you. Actually, I have one more claim with different date of service with the same patient.
[AGENT][POSITIVE] Alright, I'm ready for that next day of service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is that bill amount?
[CUSTOMER][NEUTRAL] $450 even.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We filed that claim we received on [PII] and processed and paid on [PII].
[AGENT][NEUTRAL] And paid 255 53 to provider single paper check.
[AGENT][NEUTRAL] Check number is 201.
[AGENT][NEUTRAL] 5304.
[CUSTOMER][NEUTRAL] So 2015321, right?
[AGENT][NEUTRAL] 2015304.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And claim number is 353.
[AGENT][NEUTRAL] 3669
[CUSTOMER][NEUTRAL] OK, thank you. Can you confirm the reference number?
[AGENT][POSITIVE] Call reference number? Sure, it's my name and today's date. I spell my name. Oh, I've already spelled it for you, sorry, and it's been a pleasure to assist you with that claim status, [PII]. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] For [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] No, thank you, [PII].
[AGENT][POSITIVE] And thank you for calling APL. I hope you have a wonderful day. Enjoy your weekend.
[CUSTOMER][POSITIVE] Yeah, you too. Thank you.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye.