AccountId: 011433970860
ContactId: def40231-01eb-478f-b1e8-dc5c114a807c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 751669 ms
Total Talk Time (AGENT): 179672 ms
Total Talk Time (CUSTOMER): 246746 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/def40231-01eb-478f-b1e8-dc5c114a807c_20250122T19:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this side help to last and he shall be calling from the provider office regarding the status of the claim.
[AGENT][NEUTRAL] OK, thank you, sir. And then what was your first name again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK. All right, [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name?
[CUSTOMER][NEUTRAL] Patient name is [PII]
[AGENT][NEUTRAL] OK, and then what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what's [PII]'s policy number?
[CUSTOMER][NEUTRAL] 02049543.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK, and what is the date of service?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and the charge amount?
[CUSTOMER][NEUTRAL] So, just a second. The charge amount is 369.25 cents.
[AGENT][POSITIVE] Thank you
[AGENT][NEUTRAL] Then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh, very sorry. Your voice was not clear. Can you please repeat?
[AGENT][NEUTRAL] What is the charge of amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] OK. Just a second, let me check.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, the rest is 7.69.
[AGENT][NEUTRAL] $7.69.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, and what's the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] I'm calling from All Saints Home Medical.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I'll be right back, Hulk.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, I'm back. I did find the claim for you and the claim number is 353-913-2.
[AGENT][NEUTRAL] The claim was paid with check number 2017616.
[AGENT][NEUTRAL] And the amount of the check is $7.69.
[CUSTOMER][NEUTRAL] OK. Uh, what is the check number?
[AGENT][NEUTRAL] It was issued on [PII].
[AGENT][NEUTRAL] 2017616.
[CUSTOMER][NEUTRAL] 2017.
[AGENT][NEUTRAL] 616.
[CUSTOMER][NEUTRAL] 616. It's the check number.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. 2017616 is the check number and the pay date.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] The pay date is [PII].
[CUSTOMER][NEUTRAL] OK. So it was paid on [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And it cleared the bank on.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, your voice is breaking. What did you say just right now? Clear?
[AGENT][NEUTRAL] Yes, it cleared the bank on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so, uh, can you please provide me the,
[CUSTOMER][NEUTRAL] Purchase price?
[AGENT][NEUTRAL] The what is it that you're asking for?
[CUSTOMER][NEUTRAL] Uh, purchase price for
[CUSTOMER][NEUTRAL] Line item E0431.
[AGENT][NEUTRAL] No sir, it's not done by um CPT codes or line items it's done by um.
[AGENT][POSITIVE] It helps with deductible, co-pay or co-insurance.
[AGENT][NEUTRAL] And the remaining balance was $7.69 and we paid that.
[CUSTOMER][NEUTRAL] OK. Uh, but, uh, then over here, as I'm checking, and even you stated that the benefits have been reached to the maximum limit, right?
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. So, right now,
[CUSTOMER][NEUTRAL] What we need to do on this claim, can you please assist that?
[AGENT][NEUTRAL] I can advise you on what to do and how to get paid on your claim, uh, that's determined by the provider.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. So, as you are telling that you are not having the purchase price for this one, right?
[CUSTOMER][NEUTRAL] Well that's.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] I submit the payment I have.
[CUSTOMER][NEUTRAL] Are you there?
[AGENT][POSITIVE] Uh, yes, correct, you, you are correct.
[CUSTOMER][NEUTRAL] OK, OK, can you please help me out with the received date and the processed date?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let me look for it for you real quick.
[AGENT][NEUTRAL] We received it on [PII] and processed it on [PII].
[CUSTOMER][NEUTRAL] OK. You received this claim on [PII]?
[CUSTOMER][NEUTRAL] And processed on [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Uh, can you please help out with your name?
[AGENT][NEUTRAL] With my name is [PII]
[CUSTOMER][NEUTRAL] Well I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you please help me out with the call reference number?
[AGENT][NEUTRAL] Yes, sir, you can use my name and today's date.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK. Your name and today's date.
[CUSTOMER][NEUTRAL] OK. Uh, so, what will be the timely filing limit if we send an appeal on this?
[CUSTOMER][NEUTRAL] How do you
[AGENT][NEUTRAL] You must send the appeal within 180 days from the date the claim was initially processed and you'll also need a letter as to why you want to appeal.
[CUSTOMER][NEUTRAL] OK. So 180 days from the date of
[AGENT][NEUTRAL] That the claim was initially filed.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can you help me out with the fax number?
[AGENT][NEUTRAL] Yes, our fax number is [PII].
[CUSTOMER][NEUTRAL] Is
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. Uh, the fax number you updated me is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, but there's only 2 7s, not 3.
[CUSTOMER][NEUTRAL] We need
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] So, the fax number is [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. Thanks for the information. Have a nice day.
[AGENT][POSITIVE] You have a good day too, [PII]. Thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Bye.