AccountId: 011433970860
ContactId: fd5092ed-ca25-4679-bb0e-d6e810097d71
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290119 ms
Total Talk Time (AGENT): 101517 ms
Total Talk Time (CUSTOMER): 103411 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/fd5092ed-ca25-4679-bb0e-d6e810097d71_20250213T13:55_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, this is uh [PII]. Uh, first to my last name is [PII]. I'm calling from office to check on the claim.
[CUSTOMER][NEUTRAL] Status
[AGENT][NEUTRAL] OK, [PII] is OK, what is your callback number please?
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[AGENT][NEUTRAL] Thank you. And [PII], what is the policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. Policy number, it's 027, it's 02278929.
[AGENT][NEUTRAL] OK, let me just repeat that to you, OK? One moment please, [PII]. I have that as 02278929.
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] Thank you and verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], date of birth of [PII].
[AGENT][NEUTRAL] Have that number pulled up again. You're calling for claim status and also [PII], you're able to check claim status by visiting our secure portal at [PII]. You'll be able to obtain an ELB from that website as well. Now what is that date of service and the total charge amount I can help you.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] All right. It's [PII] and the total charge amount of $2,132 even.
[AGENT][NEUTRAL] OK, and that was [PII]. Total charges $2,132 even.
[AGENT][POSITIVE] Correct? OK, thank you one moment.
[CUSTOMER][POSITIVE] You are right.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I know.
[AGENT][POSITIVE] OK, I'm almost there. Thank you for your patience.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] It shows that the claim was received and denied as the benefit maximum for this date of service had been met.
[CUSTOMER][NEUTRAL] OK. And actually, uh, previously, uh for the uh data, same data service, uh, different bill amount we have been get for the same CPD. So I just verifying that for one day or one service is only allowed for this number.
[AGENT][NEUTRAL] Per day, yes, a max of, yes.
[CUSTOMER][NEUTRAL] So one, for the, uh, yeah, so we have been billed with the uh same CPT as different uh that's why that's been uh for maximum benefit.
[AGENT][NEUTRAL] It did not because the benefit maximum for this service date of [PII] had already been met.
[CUSTOMER][NEUTRAL] Alright, and can I get the denied date for this?
[AGENT][NEUTRAL] It denied as of [PII], excuse me, [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] Uh, and, yeah, uh, can you give the uh reference, uh, can the claim time if I need to submit, sir.
[AGENT][NEUTRAL] Um, there is no timely filing limit to submit a claim and also [PII], would you like that claim number?
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK, the claim number shows 3406867.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] And the reference number would be my name [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] OK, and there is no contact claim time finding, right?
[AGENT][NEUTRAL] That is correct. There is no commonly filing limit.
[CUSTOMER][NEUTRAL] Alright and uh can I get the pay ID?
[AGENT][NEUTRAL] Of course, 60801.
[CUSTOMER][POSITIVE] 01. All right. uh, thank you so much for your assistance. You have a great day.
[AGENT][POSITIVE] You as well. Thank you for calling APM [PII]. Have a good day. Bye.
[CUSTOMER][NEUTRAL] Bye bye.