AccountId: 011433970860
ContactId: 05118e43-f249-4f1e-9c68-51b2528bf63c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 761479 ms
Total Talk Time (AGENT): 156642 ms
Total Talk Time (CUSTOMER): 265357 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/05118e43-f249-4f1e-9c68-51b2528bf63c_20250513T16:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], this is [PII] calling from provider's office to check up on a claim status. Also, this call is being recorded for quality and training purposes. Are you OK with that?
[AGENT][NEUTRAL] Yes, that's fine. OK, uh, thank you, [PII]. Uh, can I get your callback number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh yeah, it would be [PII].
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the member's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Oh, OK. I'm sorry. Can I get the policy number, please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's 02260491 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK, you have the date of service and bill charges?
[CUSTOMER][NEUTRAL] Yeah, date of service is [PII] with the total charge $450 even.
[AGENT][NEUTRAL] It looks like we received that on 5-17-2024, [PII].
[AGENT][NEUTRAL] Uh, it looks like we were needing a primary insurance explanation of benefits. Do you know when that was sent?
[CUSTOMER][NEUTRAL] Uh, actually we have already submitted primary ZB to you.
[CUSTOMER][NEUTRAL] Actually, uh,
[CUSTOMER][NEUTRAL] I do have one claim number.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And according to that claim number, the claim has been paid.
[CUSTOMER][NEUTRAL] Already
[AGENT][POSITIVE] Great, what's the claim number?
[CUSTOMER][NEUTRAL] It's uh 354-1340.
[AGENT][NEUTRAL] OK, yes, looks like that process 12-11-2024, 1216 2024.
[CUSTOMER][NEUTRAL] Actually I do have all the details like the check number as well which is uh 2018533 but actually we don't receive any payment yet.
[CUSTOMER][NEUTRAL] For this data service. So, uh, if you have a paid explanation of benefits, uh, could you please send me that?
[CUSTOMER][NEUTRAL] Through our fax
[AGENT][NEUTRAL] OK, um, yeah, I show the check is still, still outstanding. Um, can you verify the address?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Just a moment
[CUSTOMER][NEUTRAL] The address would be [PII].
[AGENT][NEUTRAL] OK, uh, looks like we have a different address that was filed with the claim.
[CUSTOMER][NEUTRAL] Actually I do have one more one more which is [PII].
[AGENT][NEUTRAL] OK, that's the address.
[CUSTOMER][NEUTRAL] Is that you have?
[AGENT][NEUTRAL] Yes, that's what we have.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So do you need the EOB still or do you want me to send it back for a reissue or?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Can you do both of the options because.
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] We don't
[AGENT][NEUTRAL] What's your fax number please?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah, it's [PII], and please give attention to my name which is [PII] spelled as [PII] my [PII] name would be [PII].
[AGENT][NEUTRAL] OK, and then do you have a good email address or callback number or um if, if by some reason the check has cleared where we would send that to or we just send it to the address on file?
[CUSTOMER][NEUTRAL] Um, I just have the callback number.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, um, I'll get this, um, explanation of benefits sent over to you um just give me a few minutes and then we'll also make sure the check has not cleared and then we'll get that reissued if it hasn't.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK thank you.
[AGENT][POSITIVE] Thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Yeah, actually I do have some more claims with me. Can you help me with those claims as well?
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And also can you help me with the turnaround time for this one?
[AGENT][NEUTRAL] For reissuing a check, it takes up to 30 days.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 30 business days.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and they have the policy number for the next patient?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Just a moment. Uh, can you help me with the call reference number as well?
[AGENT][NEUTRAL] That's my name, [PII], first initial to last name [PII], and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much. Yeah, the next policy ID number would be 01741606 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And the data service and bill charges?
[CUSTOMER][NEUTRAL] The date of service is [PII]. Uh, total charge $450 even.
[CUSTOMER][NEUTRAL] And for this one as well, the same scenario I have.
[AGENT][NEUTRAL] OK, so you have not received the claim of 37138?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Right, you have not received the payment of 371 38?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] And you need the explanation of benefits facts.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK. And did you have another plan?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, I do have.
[AGENT][NEUTRAL] OK. What's that number?
[CUSTOMER][NEUTRAL] It's 02295772 M as in Mike L as in Lima number 8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] They service and bill charges.
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII]. Total charge $5,562 even.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] It looks like we received that claim on 4-28-25 process 429-25.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] You paid 56519.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have check number or anything?
[AGENT][NEUTRAL] And check number 2041476.
[CUSTOMER][NEUTRAL] Is it 204-473?
[AGENT][NEUTRAL] No, 204-1476.
[CUSTOMER][NEUTRAL] 1476.
[CUSTOMER][NEUTRAL] OK, paid on the same date? [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Uh, can you help me with the address as well?
[AGENT][NEUTRAL] Uh, yes, one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 877
[AGENT][NEUTRAL] Um, this one was sent to [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Can you help me with the claim number?
[AGENT][NEUTRAL] number 359-545-9.
[AGENT][NEUTRAL] Did you need any more information?
[CUSTOMER][NEUTRAL] Uh, yeah, the claim number.
[AGENT][NEUTRAL] 359-545-9.
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] Yeah, thank you so much for your help.
[AGENT][NEUTRAL] OK. Anything else I can help with?
[CUSTOMER][NEUTRAL] No thank you so much. That's it. Hope you have a wonderful day.
[AGENT][POSITIVE] Thank you for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Bye-bye. Take care.