AccountId: 011433970860
ContactId: ea107a24-0759-46a7-99f9-81cdbf35b971
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1073540 ms
Total Talk Time (AGENT): 389878 ms
Total Talk Time (CUSTOMER): 321399 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/ea107a24-0759-46a7-99f9-81cdbf35b971_20250225T14:18_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII]. [PII], can you help me with? I had a, here a lot of claims that has been denied for duplicate, but in our system doesn't appear the payment, so I would like to know the check number, please. Can you help me with that?
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with that claim information. What is the callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number or if you have that claim number, the duplicate claim number, I can pull everything up by that as well.
[CUSTOMER][NEUTRAL] Yes, it's better. Give me one second. Let me find it. OK, the claim number, the first claim is 35.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 59
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 803.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] They give me one second.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And this is for data service 725?
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Vital imaging diagnostic Center.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. Yes, ma'am. That was a duplicate. The original claim we received on [PII] and processed and paid on [PII].
[AGENT][NEUTRAL] With a payment of $250 to Vital Imaging Diagnostic Center.
[CUSTOMER][NEUTRAL] And can you give me the check number or verify what's going on?
[AGENT][NEUTRAL] Mhm, check number is 200.
[AGENT][NEUTRAL] 4892.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Would you like the original claim number as well?
[CUSTOMER][NEUTRAL] Yeah, well I
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] The original claim number is 351.
[AGENT][NEUTRAL] 1013.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I mean when you don't for check the order how many claims can you check?
[AGENT][NEUTRAL] Um, I, I can check how many of you have. Give me just one second.
[CUSTOMER][POSITIVE] OK perfect I have here a so.
[AGENT][POSITIVE] Not a problem.
[AGENT][NEUTRAL] Give me just one second and I can.
[AGENT][NEUTRAL] Help you with the next. Now, on the next one, do you have the claim number or the policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No, I, I hear the claim number is gonna be 35.
[CUSTOMER][NEUTRAL] 59758.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, then let me give you the date of birth.
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It's all.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm.
[AGENT][NEUTRAL] And this data service [PII].
[CUSTOMER][NEUTRAL] That's right, mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Checking on that.
[AGENT][NEUTRAL] OK, so the original claim we received on [PII].
[AGENT][NEUTRAL] And processed and paid on [PII] in the amount of $102.83.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Check number?
[AGENT][NEUTRAL] Check number 200.
[AGENT][NEUTRAL] 4813
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] You want the claim number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 351.
[AGENT][NEUTRAL] 0991.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] I'm ready for the next one whenever you are.
[CUSTOMER][NEUTRAL] Yes, 3559953.
[CUSTOMER][NEUTRAL] Let me get [PII] let me.
[AGENT][NEUTRAL] OK, can you repeat the claim number? I don't, I must have mistyped it. I apologize.
[CUSTOMER][NEUTRAL] OK, 35.
[CUSTOMER][NEUTRAL] 599.
[CUSTOMER][NEUTRAL] 53.
[AGENT][NEUTRAL] OK, got it. Thank you. And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Let me give me 1 2nd.
[CUSTOMER][NEUTRAL] Uh, the system, OK. [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That original claim we received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Seems like we all received all the original ones on [PII].
[AGENT][NEUTRAL] And that was processed and paid on [PII].
[AGENT][NEUTRAL] $40.01.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Check number?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Check number 200.
[AGENT][NEUTRAL] 4882.
[AGENT][NEUTRAL] OK, it's 2004 and then 38, 200, yeah 4888.
[CUSTOMER][NEUTRAL] 38
[AGENT][NEUTRAL] And that claim number?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is 351.
[AGENT][NEUTRAL] 0930.
[CUSTOMER][NEUTRAL] mm.
[CUSTOMER][NEUTRAL] I'm gonna give you oh my god, yes, let me give you the, the claim number it's gonna be 35.
[AGENT][POSITIVE] And I'm ready for the next one.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 59951.
[CUSTOMER][NEUTRAL] It's the same
[AGENT][NEUTRAL] Oh, it is the same.
[CUSTOMER][NEUTRAL] Is the same let me check, yeah, but the patient did all the procedure.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm I see.
[AGENT][NEUTRAL] For 76857.
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Chicken.
[AGENT][NEUTRAL] That claim.
[AGENT][NEUTRAL] 4 CPT 76857
[CUSTOMER][NEUTRAL] That's right, mhm.
[AGENT][NEUTRAL] Received on [PII] and processed and paid on [PII].
[AGENT][NEUTRAL] For $32.36.
[AGENT][NEUTRAL] And check number 2004896.
[AGENT][NEUTRAL] And
[CUSTOMER][POSITIVE] Perfect
[AGENT][NEUTRAL] Of course you've got uh the claim number is 351-0933.
[CUSTOMER][NEUTRAL] OK perfect mhm let me check the other claim.
[CUSTOMER][NEUTRAL] You're ready?
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] 3559542.
[CUSTOMER][NEUTRAL] [PII], let me give you that day. Give me one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm born [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] While I'm getting this one looked up, I don't know if you're aware, [PII], but we do have a provider portal.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Where if you need the EOBs for these original claims, you would have instant access to those EOBs and then you have access to claim status as well as claim submission.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] That's an option for you. That is at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Good morning
[CUSTOMER][NEUTRAL] OK, I'm gonna check with my supervisor, OK, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, that is a simple self registration. It's using the tax ID number and the patient's account number listed in box 26 on the HIPA, so the patient account number is the account with the facility.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, OK, it's so easy. OK, I'm gonna check, OK?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] This original claim we received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And processed and paid on [PII].
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] The same day.
[AGENT][NEUTRAL] Mhm. And the paid amount is $190.70.
[CUSTOMER][NEUTRAL] Um-hum.
[AGENT][NEUTRAL] Check number 2004895 I'm sorry 2,004,890.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Original claim number 351.
[AGENT][NEUTRAL] 1018.
[CUSTOMER][POSITIVE] Perfect
[CUSTOMER][NEUTRAL] The next one is 35.
[CUSTOMER][NEUTRAL] C0142.
[CUSTOMER][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Anything else? Cause that's short.
[CUSTOMER][NEUTRAL] 3560142.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] 60142. Got you.
[CUSTOMER][NEUTRAL] Yeah, mhm, mhm.
[AGENT][NEUTRAL] And name and date of birth.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Let me give you the 1 2nd.
[CUSTOMER][POSITIVE] Nice to see.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Original claim received 925.
[AGENT][NEUTRAL] I bet you'll never guess what the process date was.
[AGENT][NEUTRAL] 9:27.
[CUSTOMER][NEUTRAL] I don't know what happened.
[AGENT][NEUTRAL] And pay 286 67 to the provider.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Check number.
[AGENT][NEUTRAL] 20048889.
[CUSTOMER][NEUTRAL] If originally.
[AGENT][NEUTRAL] The claim number 351.
[AGENT][NEUTRAL] 1029.
[CUSTOMER][POSITIVE] Perfect
[CUSTOMER][NEUTRAL] To more and that's it. Sorry, 3, bye.
[AGENT][POSITIVE] All right, not a problem.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 35.
[AGENT][NEUTRAL] 3.
[CUSTOMER][NEUTRAL] 59734.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] try beat, oh my god.
[CUSTOMER][NEUTRAL] Oh my god, [PII], let me give you the date of birth is gonna be.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see if this was received on [PII].
[AGENT][NEUTRAL] It was.
[AGENT][NEUTRAL] Original claim received on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Paid $70.
[AGENT][NEUTRAL] Check number 200.
[AGENT][NEUTRAL] 486 8
[CUSTOMER][NEUTRAL] 68.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And original claim number 351.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 1111, so it's 35 and then 51's. Yeah.
[CUSTOMER][NEUTRAL] Well, well
[CUSTOMER][NEUTRAL] OK, and the last one is gonna be 356-522-1.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I make you the other day I'm back.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's taking my computer a minute. I apologize.
[CUSTOMER][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, it's coming.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] We have a different date that we received this claim.
[CUSTOMER][NEUTRAL] I was it.
[AGENT][NEUTRAL] This claim we received on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this claim was processed on [PII].
[CUSTOMER][NEUTRAL] No sorry OK.
[AGENT][NEUTRAL] Mhm. Now this claim, um,
[AGENT][NEUTRAL] We need the correct explanation of benefits.
[AGENT][NEGATIVE] We did not receive the correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] I saw in the system to denial.
[CUSTOMER][NEUTRAL] The the first one is for duplicate and the second one is for the.
[CUSTOMER][POSITIVE] Yes, the explanation of benefit that's right, mhm.
[AGENT][NEUTRAL] Mhm, so we need the correct EOB matching the total and the the charges and the data service.
[CUSTOMER][POSITIVE] OK, OK, I'm gonna do that so thank you.
[AGENT][NEUTRAL] And that can be faxed.
[AGENT][NEUTRAL] That can be faxed to our claims department if you're interested in faxing it, [PII], or if you have, or if you get that um portal access, you can upload it directly on the policy.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I'm gonna check with my supervisor, so I appreciate your help. Have a great day.
[AGENT][POSITIVE] [PII], it's been my pleasure to help with that claim status, [PII]. Thank you for calling APL and I hope you have a great day as well. Take care.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Bye bye bye.
[AGENT][NEUTRAL] Bye-bye.