AccountId: 011433970860
ContactId: f0e06447-7ed9-49de-adf9-2a43dcd5d52d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 853330 ms
Total Talk Time (AGENT): 178575 ms
Total Talk Time (CUSTOMER): 317176 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/f0e06447-7ed9-49de-adf9-2a43dcd5d52d_20250509T20:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], my name is [PII] calling from the provider's office to check on some claim status for some members.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. May I please get your callback number, sir, and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Sure, my callback number is [PII] and it's a direct line.
[CUSTOMER][NEUTRAL] And the office name is Eli Imaging also called as Ecumen.
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK. So, um, the patient's name is [PII]. The, uh, policy number is 60801.
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, and that policy number you gave me is actually our payer ID number. Do you see another number for her policy number?
[CUSTOMER][NEUTRAL] Um, just a second.
[CUSTOMER][POSITIVE] Yeah got it.
[CUSTOMER][NEUTRAL] So 608201 is the uh is the payer ID?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, no, I do not see any other, uh, number. Is it possible if you could check with the name and the date of birth?
[AGENT][NEUTRAL] Yes, can you spell the first name for me?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sure. First name is [PII], spelled as [PII].
[AGENT][NEUTRAL] OK, and then the last name please?
[CUSTOMER][NEUTRAL] Last name is [PII], spelled like [PII].
[AGENT][NEUTRAL] OK, let me see if I can find her by that name.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, I have her pulled up. What is her data service and her charge amount?
[CUSTOMER][NEUTRAL] OK, date of service is [PII] and the charge amount is $863 even.
[AGENT][NEUTRAL] OK, and then what are the charges after the primary paid their part?
[CUSTOMER][NEUTRAL] So, um, like, you mean the balance amount?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. So the balance amount is $225.54.
[AGENT][POSITIVE] Thank you, sir. And it
[CUSTOMER][NEUTRAL] So, um.
[AGENT][NEUTRAL] Mhm, go ahead.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I was saying that uh the balance amount for just 2 25.54 was applied towards the uh patient's responsibility by the primary payer and then it is billed to uh the secondary payer.
[AGENT][NEUTRAL] OK, and um this facility for this member is going to be the lead imaging that you gave me at the beginning of the call?
[CUSTOMER][NEUTRAL] Yes, uh, LD imaging also called as a human.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on a quick hold while I look up this claim and I'll be right back with you.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Sure, take your time.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you, [PII], for holding for me. So looking on data service of [PII], I do not find a claim on file for that date of service.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] So, um, I do see we had a bill this claim, uh,
[CUSTOMER][NEUTRAL] Through paper and the mailing ID, the, uh the mailing address used was uh [PII]. Uh just a second.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, it is [PII]. Is that the, uh, correct address for claims?
[AGENT][NEUTRAL] No, no, sir. Let me give you the good address.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The good address is [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, and the PR ID is uh 60801, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Thank you so much. um, and yeah, also can you, uh, tell me the timely filing limit to some of the claim?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We do not have one.
[CUSTOMER][POSITIVE] OK, thank you so much for that and uh Tri can you also check two more patients for me?
[AGENT][NEUTRAL] Yes, can you give me the patient name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes. So, the next patient's name is [PII]. Date of birth is [PII]. Policy number is 02586053.
[AGENT][NEUTRAL] OK, let me pull that policy up real quick.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK and then what is the data service and charge amount for this one?
[CUSTOMER][NEUTRAL] Data service is uh [PII]. And the total bill amount is $863 out of which the balance is 3 $31.35.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on a quick hold while I look this one up and I'll be right back sir.
[CUSTOMER][POSITIVE] Sure, take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] That one's not on here either.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you [PII] for holding for me. So on this one I'm also not finding a claim on file for date of service of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Mhm. OK. Thank you so much for that information.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] And uh yeah. Actually, uh yeah, thank you so much for this uh patient. Actually, I just uh missed to ask you for the uh correct member ID for that previous patient. So is it possible if you could provide me the correct policy number?
[CUSTOMER][NEUTRAL] The previous patient?
[AGENT][NEUTRAL] Mm, yeah, let me see if I can find her again.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let me look her up again.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I know
[AGENT][NEUTRAL] OK, the correct policy number is 247.
[AGENT][NEUTRAL] 331 4.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK. Thank you so much for that information.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And uh yeah I'll I'll uh move on to the last member.
[AGENT][NEUTRAL] OK, what's their name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Policy number is 02411129.
[CUSTOMER][NEUTRAL] M. like Mary, L like Lima, the number 8.
[CUSTOMER][NEUTRAL] The member's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, let me look up this one.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and then what is the date of service and the charge amount?
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] Day of service is uh [PII] and the charge amount is uh $3650 even.
[AGENT][NEUTRAL] And then charges after primary?
[CUSTOMER][NEUTRAL] Yes, um.
[CUSTOMER][NEUTRAL] Just a second.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Uh yes, uh primary, it is $459.88.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold for this one also, and I'll be right back sir.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you [PII] for holding for me and we've got the same situation with this one there is no claim on file.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. Yeah, I guess uh we billed all this claim to the incorrect mailing address, so that's the reason why, yeah.
[AGENT][NEUTRAL] Yes, that's what I'm thinking.
[CUSTOMER][NEUTRAL] Mhm. Yeah, so, um, no problem. Thank you so much for that information, [PII]. And lastly, um, do you have a reference number for this call?
[AGENT][NEUTRAL] Yes, sir. You can use my name, [PII]. It's [PII] and today's date.
[CUSTOMER][POSITIVE] OK, OK then, [PII], thank you so much for your assistance and have a great day. Take care bye bye.
[AGENT][POSITIVE] Yes, you have a wonderful weekend, [PII]. Thank you for calling APL. Bye-bye, sir.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.