AccountId: 011433970860
ContactId: 009cd06e-120c-428a-852e-9b1db6f6108d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 609409 ms
Total Talk Time (AGENT): 193118 ms
Total Talk Time (CUSTOMER): 170585 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/009cd06e-120c-428a-852e-9b1db6f6108d_20250521T19:31_UTC.wav
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[AGENT][NEUTRAL] Yeah, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, and uh, my name is [PII] and I'm calling you from the provider office. I just want to know the claim status. Can you please help me, [PII]?
[AGENT][POSITIVE] Sure, I'll be more than happy to assist you with the claim status, and may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number, OK, sorry for that. Uh, the callback number is [PII].
[AGENT][NEUTRAL] Thank you. And how many claims do you have in total today, [PII]?
[CUSTOMER][NEUTRAL] Only one.
[AGENT][NEUTRAL] All right. And the policy number?
[CUSTOMER][NEUTRAL] Single game.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Policy number is uh.
[CUSTOMER][NEUTRAL] 02389383
[AGENT][POSITIVE] Thank you for that. Hold on one moment.
[AGENT][NEUTRAL] And can you
[CUSTOMER][NEUTRAL] And what is your name? Can you spell out your name?
[AGENT][NEUTRAL] Yes, my name is [PII] The first initial to my last name is.
[CUSTOMER][NEUTRAL] Last initial.
[AGENT][NEUTRAL] The first initial and my last name is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. I'm giving you the information you need. Just give me a moment, OK? It's [PII]. It's OK.
[CUSTOMER][POSITIVE] OK. Sorry for that.
[CUSTOMER][POSITIVE] OK. Sorry for that, ma'am.
[AGENT][NEUTRAL] It's fine. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] I'm checking one moment. The member first name is [PII] and last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the the amount is $1,612.60.
[AGENT][NEUTRAL] And it
[AGENT][NEUTRAL] And 60 cents, you said?
[CUSTOMER][NEUTRAL] Yeah, 1612.60.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold while I locate the claim?
[CUSTOMER][POSITIVE] Yeah. Yeah, yeah. Take your time.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Now what happened now?
[AGENT][NEUTRAL] So it's included in this.
[AGENT][NEUTRAL] Yeah, could you do it or is it this?
[AGENT][NEUTRAL] I'm gonna look at both of them. Either way, it goes 78.
[AGENT][NEGATIVE] Is a dupe and 81 is a dupe.
[AGENT][NEUTRAL] So then we'll go to this.
[AGENT][NEUTRAL] Let's do 28.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, wait a minute.
[AGENT][NEUTRAL] Oh, OK, OK, I got it. But it was only it was only billed 360, so of the 362 went to the deductible. The other was paid to the provider cause it would have been, OK, I got it.
[CUSTOMER][NEUTRAL] You are
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for the wait. Um, so I have located the claim. Um, so we received the claim on [PII].
[CUSTOMER][NEUTRAL] One moment, so please just speak slowly, slowly. I have to note down all things for uh one moment. he was.
[CUSTOMER][NEUTRAL] Uh, received on, yeah, please go ahead. I received it.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 3
[CUSTOMER][NEUTRAL] That's.
[AGENT][NEUTRAL] The claim number is 354.
[AGENT][NEUTRAL] 46.
[CUSTOMER][NEUTRAL] 353.
[CUSTOMER][NEUTRAL] 5446.
[AGENT][NEUTRAL] 01
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], we paid out on the claim a total.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] One moment ma'am. Actually my system is taking loading. Sorry for that. So as you said the claim has been paid, right? Mhm.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Yes, part was paid to the provider and the other part was applied to the deductible.
[CUSTOMER][NEUTRAL] He has been.
[CUSTOMER][NEUTRAL] OK, OK, what is this you done?
[CUSTOMER][NEUTRAL] At
[CUSTOMER][NEUTRAL] Green has paid on.
[CUSTOMER][NEUTRAL] Uh, can you repeat one more time the paid amount, uh, sorry, pay date.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is the paid amount?
[AGENT][NEUTRAL] So $160 was paid to the provider?
[AGENT][NEUTRAL] The other 200.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] was applied to the emergency room deductible.
[CUSTOMER][NEUTRAL] OK, so as you said, the PR amount is 200.
[CUSTOMER][NEUTRAL] As deductible.
[CUSTOMER][NEUTRAL] Well, OK, got it. Is there any check number?
[AGENT][NEUTRAL] Yes, hold on one moment, let me get that for you.
[AGENT][NEUTRAL] OK, so it was a single check in the amount of $160.
[AGENT][NEUTRAL] Check number 201.
[AGENT][NEUTRAL] 9905.
[AGENT][NEUTRAL] It was issued on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it cleared on [PII].
[CUSTOMER][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] 5
[CUSTOMER][NEUTRAL] OK, so we do not have the UB. I'm giving you the fax number. Please send us the UB.
[CUSTOMER][POSITIVE] You thanks.
[CUSTOMER][NEUTRAL] Are you ready to take the fax number?
[AGENT][POSITIVE] Yes, I'm ready.
[CUSTOMER][NEUTRAL] OK, the fax number is [PII]. Attention to Ealha [PII] India [PII].
[AGENT][NEUTRAL] I'm sorry, can you repeat the attention again?
[CUSTOMER][NEUTRAL] In the, uh, sorry,
[CUSTOMER][NEUTRAL] Yeah, A D David India Tango Alpha Yankee Alpha [PII] Kumar and then space Kumar, [PII]
[AGENT][NEUTRAL] So, Alpha, [PII], indigo, [PII], Alpha, yellow, Alpha, [PII] then Kumar?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] And the fax number is [PII]?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] Alright, so I'll go ahead
[CUSTOMER][NEUTRAL] So what is the turnaround time when we can get the, when we can get the UB?
[AGENT][POSITIVE] Yes, I was just getting ready to let you know. I'll be sending the um fax to you now, so you should be receiving that in a few minutes. If you have not received it by end of day today, just give us a call and we'll be more than happy to resend it for you.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, sure, so what is the call reference number and uh for this one?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] 0521 2025.
[AGENT][NEUTRAL] And was there anything else I could assist you with today, [PII]?
[CUSTOMER][POSITIVE] Nothing else and uh thank you so much for giving me the information. Have a good day.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][POSITIVE] Thank you.