AccountId: 011433970860
ContactId: e7dca683-39f2-4899-81dd-499ac0b0a40d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 309899 ms
Total Talk Time (AGENT): 97068 ms
Total Talk Time (CUSTOMER): 109180 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/e7dca683-39f2-4899-81dd-499ac0b0a40d_20250109T15:00_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, this is [PII] calling from provider's office and I wanted to know the claim status.
[AGENT][NEUTRAL] What is your call back [PII] we're disconnected?
[CUSTOMER][NEUTRAL] [PII] and that's a direct line.
[AGENT][NEUTRAL] Thank you. What is your policy number, please?
[CUSTOMER][NEUTRAL] 024
[CUSTOMER][NEUTRAL] 93395 M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you so much, [PII]. You can also check claim status. Let me provide you with the website. It is [PII]. Again that's secured. [PII] and on that website you'll be able to obtain an EOB as well. And what is the date of service and the charge amount please?
[CUSTOMER][NEUTRAL] [PII], with the bill amount $752 even, that that is $752.
[AGENT][NEUTRAL] OK, that was 752.
[AGENT][POSITIVE] Even, OK, thank you.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] to
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, if you would give me the procedure code or codes bill for the service state for the member procedure codes.
[CUSTOMER][NEUTRAL] So this is for the medical claim, OK.
[AGENT][NEUTRAL] OK, do you have the procedure codes or codes bill for the service date for the number? Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, there are
[CUSTOMER][NEUTRAL] There are 4 codes of the bill.
[CUSTOMER][NEUTRAL] The first is 99204.
[CUSTOMER][NEUTRAL] And the second is J as in Juliet, 2919.
[CUSTOMER][NEUTRAL] And the third is 963-72.
[CUSTOMER][NEUTRAL] Fourth is 94,640 and the 5th is J as in Juliet 7620.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[AGENT][POSITIVE] OK, thank you so much for your patience. I was able to locate the claim. Thank you for providing that information. It shows that we made a payment of $80 on this claim.
[CUSTOMER][NEUTRAL] When did you guys receive the claim?
[AGENT][NEUTRAL] OK, the claim was received one moment.
[AGENT][NEUTRAL] The claim was received on [PII] and processed [PII].
[CUSTOMER][NEUTRAL] OK, it was processed and paid on [PII], right?
[AGENT][NEUTRAL] No, the claim was received on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah. And uh what is the allowed amount?
[AGENT][NEUTRAL] $80
[CUSTOMER][NEUTRAL] And the paid amount?
[AGENT][NEUTRAL] $80.
[CUSTOMER][NEUTRAL] OK, there's no member's responsibility, right?
[AGENT][NEUTRAL] APL does not determine the patient's responsibility.
[CUSTOMER][NEUTRAL] And what is the mode of payment, check or EFT?
[AGENT][NEUTRAL] It's a single paper check and the check number shows 2,018,530.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] And when, when was the check issue?
[AGENT][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] Claim number?
[AGENT][NEUTRAL] 3541647
[CUSTOMER][NEUTRAL] 354
[AGENT][NEUTRAL] 1647.
[CUSTOMER][NEUTRAL] Would you please spell out your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Last name [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Call reference number.
[AGENT][NEUTRAL] We do not provide reference numbers. You can use my name in today's date. Anything else I can help you with [PII]?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] Thank you so much for calling APL. Have a great day bye.