AccountId: 011433970860
ContactId: eb185c1a-4ac2-440b-b8f7-bed63eefccde
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362040 ms
Total Talk Time (AGENT): 104330 ms
Total Talk Time (CUSTOMER): 157602 ms
Interruptions: 4
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/eb185c1a-4ac2-440b-b8f7-bed63eefccde_20250129T16:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office. How are you doing today?
[AGENT][POSITIVE] I'm doing good, [PII]. How are you doing today?
[CUSTOMER][POSITIVE] I'm good thanks for asking.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Actually, uh, I received a claim status, uh, from [PII], and, uh, uh, I just need to confirm a check number. Claim number is going to be 355-0617.
[AGENT][NEUTRAL] OK, thank you [PII], and what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] But uh
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's name?
[CUSTOMER][NEUTRAL] Uh patient's first name is [PII] and the last name is [PII]
[CUSTOMER][NEUTRAL] OK yeah.
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] be
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The.
[AGENT][NEUTRAL] Thank you. And his policy number, please?
[CUSTOMER][NEUTRAL] Uh, policy number is going to be 02274042.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Maybe.
[CUSTOMER][NEUTRAL] Yeah, I guess I think.
[CUSTOMER][POSITIVE] love
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, I've got the claim pulled up. I've got the uh the check number for you. It is.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, what is the charge amount first? What was the charge amount?
[CUSTOMER][NEUTRAL] Uh charge amount is going to be $895.06.
[AGENT][NEUTRAL] OK and what was the charge after the primary paid their part?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Oh, I'm sorry. I see it here. Never mind, I found it.
[CUSTOMER][NEUTRAL] Yellow
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Emily's Medical Group.
[AGENT][NEUTRAL] OK, I do find the check for $75. The check number is 2022368.
[CUSTOMER][NEUTRAL] But it's
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, 202-2368, is that correct?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] And uh should date.
[AGENT][NEUTRAL] Let me look for you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The issue date was [PII], no, I'm sorry, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hey, is it clear or not?
[CUSTOMER][NEUTRAL] What was that?
[AGENT][POSITIVE] No, it's still outstanding.
[CUSTOMER][NEUTRAL] OK, mm.
[CUSTOMER][NEUTRAL] Can you please confirm me the denial codes?
[AGENT][NEUTRAL] Uh yes, sir. Let me look real quick at the EOB again.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] The calendar year maximum on the wellness diagnostic benefit has been met.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] With this check, the maximum benefit payable for this data service was met.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome. there is anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, can you please assist me uh.
[CUSTOMER][NEUTRAL] how we can uh.
[CUSTOMER][NEUTRAL] Resubmit claim uh for uh other CBT uh need to process.
[AGENT][NEUTRAL] The claim was processed and paid.
[AGENT][NEUTRAL] After it was paid, it max up benefits for that data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Uh, can you have name? Can I, can I have your name?
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] Mm, can you spell it for me?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] In the
[CUSTOMER][NEUTRAL] and call reference number?
[AGENT][NEUTRAL] Yes sir, you can use my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. You have a good day and thank you for calling APL.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And you too bye.
[AGENT][NEUTRAL] Bye-bye.