AccountId: 011433970860
ContactId: e4071260-9157-410a-9eb3-42dc2e931922
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 595979 ms
Total Talk Time (AGENT): 115362 ms
Total Talk Time (CUSTOMER): 107969 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/e4071260-9157-410a-9eb3-42dc2e931922_20250527T21:37_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office to check the claim status.
[AGENT][NEUTRAL] Yeah, I can help you with claim status. [PII], do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Policy number of the patient?
[CUSTOMER][NEUTRAL] 0243 consecutive 3.
[CUSTOMER][NEUTRAL] And 00.
[AGENT][NEUTRAL] OK, what was it? 024333 what?
[CUSTOMER][NEUTRAL] 00.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Date of service and bill charges.
[CUSTOMER][NEUTRAL] Yeah, date of service is uh [PII] and bill amount is uh $13,193.
[CUSTOMER][NEUTRAL] 25 cents.
[AGENT][NEUTRAL] OK, it was [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the bill charges?
[CUSTOMER][NEUTRAL] $13,193.25.
[AGENT][NEUTRAL] Uh, claim was received 4 12025. Process 44-2025.
[CUSTOMER][NEUTRAL] When it was processed?
[AGENT][NEUTRAL] Claim was received for 12025, process 44-2025.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we have primary, uh, it says the insurance primary insurance provided full benefits, therefore, no benefits are payable.
[CUSTOMER][NEUTRAL] What should we do for the next step?
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Next step for what?
[CUSTOMER][NEUTRAL] What is the exact reason of this claim is denied?
[AGENT][NEUTRAL] The claim is denied because the primary insurance paid in full, so we didn't have anything left to pay.
[CUSTOMER][NEUTRAL] I do have the primary UB. Could you send it back for the review?
[AGENT][NEUTRAL] OK, let me pull up what we received.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Uh, it doesn't show any patient responsibility.
[AGENT][NEUTRAL] So do you have an EOB that shows patient responsibility or?
[AGENT][NEUTRAL] Anything applied to the deductible?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, I do have that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You wanna fax it over or?
[CUSTOMER][NEUTRAL] Can we rea uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get the mailing address?
[AGENT][NEUTRAL] Mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And can I get the fax number?
[AGENT][NEUTRAL] Fax number is [PII].
[CUSTOMER][NEUTRAL] Can I get the timely filing limit?
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] Can I get the claim number?
[AGENT][NEUTRAL] My number is 358-540-6.
[CUSTOMER][NEUTRAL] Can you spell out your name, please?
[AGENT][NEUTRAL] [PII], it's [PII]
[CUSTOMER][NEUTRAL] I do have another claim. Could you help me with that?
[AGENT][NEUTRAL] For the same patient or a different one?
[CUSTOMER][NEUTRAL] Different one.
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] It's 022.
[CUSTOMER][NEUTRAL] 039
[CUSTOMER][NEUTRAL] 26 ML 8.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, patient's name and date of birth is uh.
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Data service and bill charges.
[CUSTOMER][NEUTRAL] Date of service is uh
[CUSTOMER][NEUTRAL] Number 24 2 24 and bill amount is $17,356.
[CUSTOMER][NEUTRAL] Even.
[AGENT][NEUTRAL] Claim was received on [PII].
[CUSTOMER][NEUTRAL] One moment. One moment, please.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah. Can I get the receipt date and denied it?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Receive date [PII].
[AGENT][NEUTRAL] Denial [PII].
[AGENT][NEUTRAL] We need the primary explanation of benefits.
[CUSTOMER][NEUTRAL] Yeah, we have already submitted the primary uh did you receive that?
[AGENT][NEGATIVE] No, we have not received it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is the mailing address and the fax number is same which you have provided previously?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And can I get the claim number?
[AGENT][NEUTRAL] Same number 3563048.
[CUSTOMER][POSITIVE] OK. Thank you so much for providing the information. Have a nice day. Thank you.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye-bye.