AccountId: 011433970860
ContactId: e6db1d92-47aa-4d7e-85e9-f59fe2f51208
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 339459 ms
Total Talk Time (AGENT): 87980 ms
Total Talk Time (CUSTOMER): 70803 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/e6db1d92-47aa-4d7e-85e9-f59fe2f51208_20250219T18:43_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL this is [PII] how may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office, checking on a claim status.
[AGENT][NEUTRAL] OK [PII], I can help you with claim status. Can you please give me your callback number?
[CUSTOMER][NEUTRAL] [PII]. No extension direct line.
[AGENT][NEUTRAL] Thank you and then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Policy number is 148431.
[CUSTOMER][NEUTRAL] 4 M as in Mary, L as in Lima, 8.
[CUSTOMER][NEUTRAL] And the date of birth is [PII] and the member name is [PII].
[AGENT][NEUTRAL] OK, let me look up that policy number real quick.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what is the data service for um [PII]?
[CUSTOMER][NEUTRAL] Date of service is [PII] and total charges of $3480 even 3480.
[AGENT][NEUTRAL] OK, and then what is the amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] The, the leftover balance is $478.80.
[AGENT][NEUTRAL] OK and the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Gastrohealth.
[CUSTOMER][NEUTRAL] Sorry, Galloway Anesthesia Associate. It's a part of gastrohealth.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up that claim for you and I'll be right back, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, [PII]. I do have um the claim pulled up. The claim number is 3502539. The claim was denied because we need.
[AGENT][NEUTRAL] The explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] OK. D for primary yogurt.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. May I know when was the claim received?
[AGENT][NEUTRAL] It was received on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] OK. After that, you haven't received any claim?
[AGENT][NEUTRAL] No, we received the claim.
[AGENT][NEGATIVE] We haven't received the EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you. Can you spell your name for my documentation?
[AGENT][NEUTRAL] Yes sir, it's [PII]
[CUSTOMER][NEUTRAL] OK, may, is there any timely filing limit to submit the primary OB?
[AGENT][NEUTRAL] No, sir.
[CUSTOMER][NEUTRAL] Thank you. Patient is patient active for the date of service?
[AGENT][NEUTRAL] Uh, the patient's effective date is [PII] and the policy is still active.
[CUSTOMER][POSITIVE] Thank you for your assistance. Have a great day. Can I have the call reference number?
[AGENT][NEUTRAL] You too, you have
[AGENT][NEUTRAL] Yes, [PII], you can use my name and today's date.
[CUSTOMER][POSITIVE] Thank you for your assistance.
[AGENT][POSITIVE] You're very welcome. You have a good day and thank you for calling APL sir.
[AGENT][NEUTRAL] Bye-bye.