AccountId: 011433970860
ContactId: e8fbfdb9-05a4-496a-b982-ac63b6c56b47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288450 ms
Total Talk Time (AGENT): 92426 ms
Total Talk Time (CUSTOMER): 105718 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/e8fbfdb9-05a4-496a-b982-ac63b6c56b47_20250115T20:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. And I'm calling for a provider to check on additional information about a claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes. Good afternoon. How are you doing today?
[AGENT][POSITIVE] I'm good, [PII]. Thank you for asking. I'm happy to check on a claim for you today. What is the patient's policy number?
[CUSTOMER][NEUTRAL] Policy number is 020.
[CUSTOMER][NEUTRAL] 274
[CUSTOMER][NEUTRAL] 28
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] All right, thank you for that, [PII]. One moment. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, the callback number is [PII]. It is a direct line.
[AGENT][POSITIVE] All right. Thank you so much. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. And then what is the date of service?
[CUSTOMER][NEUTRAL] Data service on [PII].
[AGENT][NEUTRAL] In the build amount?
[CUSTOMER][NEUTRAL] And the bill amount is 1, it is $825.84.
[AGENT][POSITIVE] All right, thank you so much. One moment.
[CUSTOMER][NEUTRAL] Welcome.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. So it looks like we did receive a claim um on [PII]. Claim was denied. Services are not covered when performed in a doctor's office or clinic.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Go.
[CUSTOMER][POSITIVE] Got it, thank you. One quick moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is it not covered under the patient's plan when a service is performed in a doctor's office or a clinic?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Got it. And could you tell me the plan type of the patient?
[AGENT][NEUTRAL] We are the secondary insurance, so supplemental.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] And for the claim number, does it end with 2508?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] And the claim denial date was it on [PII]?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Got it, thank you.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Did you receive uh another claim which got denied as a duplicate the claim number which ends with 3154?
[AGENT][POSITIVE] Uh, yes, that is correct.
[CUSTOMER][NEUTRAL] Got it, thank you. And the denial date was on [PII]?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Got it thank you one quick moment.
[CUSTOMER][NEUTRAL] And may I have your contact claim mailing address?
[AGENT][NEUTRAL] Uh, claim mailing address is gonna be [PII].
[AGENT][NEUTRAL] That's in [PII]. Zip code is [PII].
[CUSTOMER][NEUTRAL] For the zip code, does it have any four digit extension?
[AGENT][NEUTRAL] Uh, the four numbers after that would be 8950.
[CUSTOMER][NEUTRAL] And do you have a payer ID?
[AGENT][NEUTRAL] Yes, that would be 60801.
[CUSTOMER][NEUTRAL] And what is the timely filing limit for submitting a credit claim?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] May I have a reference number for our call?
[AGENT][NEUTRAL] Call reference will be my name with my last initial and today's date. My name again is [PII], that's [PII] Last initial to my name is [PII].
[CUSTOMER][POSITIVE] Got it, sir. That will be all. Thank you so much for your assistance. Have a great day and take care. Bye for now.
[AGENT][NEUTRAL] You too. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.