AccountId: 011433970860
ContactId: dc04d51c-57a8-4ea0-8e30-cb6058905bbe
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 656909 ms
Total Talk Time (AGENT): 231525 ms
Total Talk Time (CUSTOMER): 149640 ms
Interruptions: 3
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/dc04d51c-57a8-4ea0-8e30-cb6058905bbe_20250410T15:10_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 [PII], this is [PII] calling from Bor's office. I'm checking on a denied claim status. Could you help me with that?
[AGENT][POSITIVE] It would be my pleasure to assist you with that claim status, [PII]. What is a good call back number please?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. [PII], do you have that claim number or the patient's policy number?
[CUSTOMER][POSITIVE] Thank you [PII]
[CUSTOMER][NEUTRAL] Yes, it is 253-626-7.
[AGENT][NEUTRAL] Thank you, [PII] and the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] The patient's name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] Uh, yes, the date of service is [PII].
[AGENT][NEUTRAL] And [PII], what is the bill amount?
[CUSTOMER][NEUTRAL] And the total bill amount is 2 yes it is $265 even.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 265.
[AGENT][NEUTRAL] And what is the facility name, please?
[CUSTOMER][NEUTRAL] It is radiology imaging associates.
[AGENT][POSITIVE] Alright, thank you [PII], and it would be my pleasure to assist you with that claim status. Give me just one second. I'm pulling up that received date if you don't mind holding.
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] I do apologize my computer is.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] Thinking.
[AGENT][NEUTRAL] OK, that claim we did receive on [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Now this claim was denied.
[AGENT][NEUTRAL] As the calendar year maximum for diagnostic services has been met.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, this is PT 71275, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, just a moment.
[CUSTOMER][NEUTRAL] Uh, do you have an option to send the UB through fax?
[AGENT][NEUTRAL] Actually our faxes are available on our provider portal at [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] And you can get that EOB instantly. I can help you with that if you'd like.
[CUSTOMER][POSITIVE] I can help you with that.
[CUSTOMER][NEUTRAL] Uh, but, uh, for the same reason, another data service, uh, previously we requested a fax and it was sent that.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] You have option to send this uh CPT. I just want that.
[AGENT][POSITIVE] I mean I can I can I was just letting you know that we do have that portal and you can it will download instantly.
[CUSTOMER][NEUTRAL] You that
[AGENT][NEUTRAL] But I can fax.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It'll take me just a moment to see uh if you'll bear with me.
[CUSTOMER][NEUTRAL] if you.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's taken a while, so bear with me.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][POSITIVE] OK, take your time.
[AGENT][POSITIVE] Yeah, if you're ever interested in that portal you'll have access to check claim status, EOBs, and you can even submit claims online.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Instead of having to wait for a fax.
[AGENT][NEUTRAL] It'll download load that EOB immediately.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Uh, just a moment.
[AGENT][NEUTRAL] And I can help you create an account.
[AGENT][NEUTRAL] It's a self registration site. All you need is the tax ID number and the patient's account number listed in box 26 on the HPA.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] about
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] At the moment my stomach is a little loading.
[AGENT][NEUTRAL] That's fine. You wanna go ahead and give me that fax number? I'm, I'll go ahead and send this, but if you'd like, I can help you create an account as well.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Oh yes, it does.
[CUSTOMER][NEUTRAL] 352-234.
[CUSTOMER][NEUTRAL] 8952.
[AGENT][NEUTRAL] And just to verify that fax number, [PII], I'm sending this to 352.
[AGENT][NEUTRAL] 234-8952, is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] All right, that is on the way for you and when your system gets ready, if you'll go to [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh just a moment.
[CUSTOMER][POSITIVE] Yes, I'm ready. I'm logging that.
[AGENT][NEUTRAL] OK, so you're if you go in as a new user.
[AGENT][NEUTRAL] And you're going to choose uh the
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Bottom option on the medical or general provider.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] On the next page you're gonna put in the tax ID number.
[CUSTOMER][NEUTRAL] You.
[AGENT][NEUTRAL] And when it comes to the patient account I can provide that so you don't have to look it up.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, I get that.
[AGENT][NEUTRAL] Patient account number is R as in Romeo A as in Alpha, D as in Delta.
[CUSTOMER][NEUTRAL] Are
[AGENT][NEUTRAL] 205337
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We need to create the user name and password, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, it was log in.
[AGENT][NEUTRAL] OK, so if you need claim status and you have a claim number, you would choose option one for the quick access option. So in this case, you can just put in the patient's, I think it's first name, date of birth, and the claim number and it will download the EOB immediately.
[CUSTOMER][NEUTRAL] For the
[CUSTOMER][NEUTRAL] She just
[CUSTOMER][NEUTRAL] Yes first name date of birth is the.
[CUSTOMER][NEUTRAL] Immediately
[CUSTOMER][NEUTRAL] OK. First name, date of birth.
[CUSTOMER][NEUTRAL] OK, you already sent or uh mhm.
[AGENT][NEUTRAL] If you don't have the claim number.
[AGENT][NEUTRAL] Yeah, I did fax it to you. If you don't have a claim number, you can use option 2. You will have to have the last 4 of the policyholder's social.
[CUSTOMER][NEUTRAL] Yeah, I did fax it if you don't have.
[CUSTOMER][NEUTRAL] you will.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then if you need to submit claims, you can submit claims online as well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] claim
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] So I think you'll enjoy that website.
[CUSTOMER][POSITIVE] Thank you, thank you for holding this.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you for that.
[AGENT][POSITIVE] It's my pleasure, [PII]. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh no, do you have a reference for this call?
[AGENT][NEUTRAL] Reference number is my name and today's date, and I spell my name [PII]
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] First initial last name [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you. Thank you for supporting this information.
[AGENT][POSITIVE] It's my pleasure, [PII]. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] Well thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Have a wonderful day. Bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.