AccountId: 011433970860
ContactId: e0f88d00-880e-4d33-a1dc-e7edecf55f26
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 775590 ms
Total Talk Time (AGENT): 168068 ms
Total Talk Time (CUSTOMER): 113457 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=-1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/e0f88d00-880e-4d33-a1dc-e7edecf55f26_20250603T15:09_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, hi, my name is [PII] and I'm calling from provider office. I want to know the claim status only.
[AGENT][NEUTRAL] OK, I'll be glad to help you, but I am so sorry I did not catch your name.
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] Alright, [PII], go ahead and give me a good policy number, please, sir.
[CUSTOMER][NEUTRAL] Policy number is 01972970.
[AGENT][POSITIVE] Alright, [PII], thank you so much for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number please, sir.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] Uh, with extension [PII].
[AGENT][NEUTRAL] All right, thank you for that, [PII]. Now your patient's name and date of birth today, please, sir?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Uh, date of birth is [PII].
[AGENT][NEUTRAL] Alrighty, thank you for that, [PII]. You did say you want to check status of a claim, is that correct?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, I want to know the claim status only.
[AGENT][NEUTRAL] OK, data service.
[CUSTOMER][NEUTRAL] Uh, date of service is [PII].
[AGENT][NEUTRAL] And your total bill, [PII]?
[CUSTOMER][NEUTRAL] Uh, bill amount is $250.09.
[AGENT][NEUTRAL] And where is your bill from?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Where's the bill from? What's the provider name?
[CUSTOMER][NEUTRAL] Provider name is Beacon Respiratory Services of Georgia.
[AGENT][NEUTRAL] Alrighty, thank you so much, [PII] for that information. Looks like we do have that claim. It's been processed and the eligible amount has applied towards this patient's deductible. Patient has a deductible of $1500 to meet here at APL before we pay anything.
[AGENT][NEUTRAL] So, um, that has been processed and it did apply towards that deductible. You want me to fax you over an EOB, [PII]?
[CUSTOMER][NEUTRAL] Uh, what is the deductible amount?
[AGENT][NEUTRAL] And I'm sorry, what was your question?
[CUSTOMER][NEUTRAL] What is the deductible amount?
[AGENT][NEUTRAL] $1500.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] 1500.
[CUSTOMER][NEGATIVE] Wait, uh, your voice is not clear.
[AGENT][NEUTRAL] Can, can you hear me now?
[CUSTOMER][NEUTRAL] Yeah, now I can hear you.
[AGENT][NEUTRAL] Yeah, the
[AGENT][NEUTRAL] Deductible amount is 1500 1500.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's a deductible amount.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] You want me to fax you over an EOB?
[CUSTOMER][NEUTRAL] And uh what is the claim number?
[AGENT][NEUTRAL] Your claim number 3.
[AGENT][NEUTRAL] 52.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 6499.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK, we need you be uh this claim, you can send us uh over the text also.
[AGENT][NEUTRAL] Yeah, I'll be glad to fax you over an EOB. I need a fax number, [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] 888
[CUSTOMER][NEUTRAL] 99859.
[AGENT][NEUTRAL] Uh, say that one more time for me, please, sir.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, got that time. OK, give me about 5 minutes, [PII], and I'll get that EOB faxed over to you and is that all that I can help answer for you today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry, how much time it will take?
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] About 5 minutes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All righty, [PII].
[CUSTOMER][NEUTRAL] Uh, now, I have another date of service for the same member.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure, what day of service is that?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[CUSTOMER][NEUTRAL] And the bill amount is.
[CUSTOMER][NEUTRAL] $215.22.
[AGENT][NEUTRAL] Alright, let's see. Yeah, we do have that claim in as well, [PII], and it did apply towards that same deductible. I will fax that EOB over to you as well.
[CUSTOMER][NEUTRAL] Uh, actually, I want to know about A687038.
[AGENT][NEGATIVE] Uh, 7038 is not a covered benefit here at all ever.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEGATIVE] The the procedure code you're asking about 7038 is not covered.
[CUSTOMER][NEGATIVE] It's not covered.
[AGENT][MIXED] Correct, not covered.
[CUSTOMER][NEUTRAL] So this is the patient responsibility?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And it's not covered under the patient plan?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Or something.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] You're welcome, [PII], and is that all that I can help you with on this patient?
[CUSTOMER][NEUTRAL] Uh, no, now I have uh another member ID.
[AGENT][NEUTRAL] You have a what?
[CUSTOMER][NEUTRAL] I have another member ID now.
[AGENT][NEUTRAL] Oh, OK. Well, hold on just a moment for me, [PII], OK?
[CUSTOMER][NEUTRAL] Sure, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] We ain't doing it no more.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] [PII] web provider.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Oh