AccountId: 011433970860
ContactId: 0b169e66-e05e-4f5e-b2e5-a42768c603ff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 414309 ms
Total Talk Time (AGENT): 166805 ms
Total Talk Time (CUSTOMER): 121086 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/0b169e66-e05e-4f5e-b2e5-a42768c603ff_20250110T13:22_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. This is [PII]. I'm calling for provider Valley physician service. Please be informed this call is being recorded and monitored for quality and training purposes. I'm calling to check on the claim status.
[AGENT][NEUTRAL] OK, [PII], you have one claim that you're needing status on, is that correct?
[CUSTOMER][POSITIVE] That's right.
[AGENT][POSITIVE] Yes, sir. I can help you with that, [PII]. And give me just one second, please.
[AGENT][NEUTRAL] OK, and first off, [PII], what is a good call back number for you?
[CUSTOMER][NEUTRAL] My direct line is [PII].
[AGENT][NEUTRAL] OK, [PII] and, is there an extension because I've tried calling that number before and that doesn't take me directly to one person.
[CUSTOMER][NEUTRAL] No, that's what I.
[CUSTOMER][NEUTRAL] No, it is said that no.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't have an extension.
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] 01994046 M as in Mike, L as in Larry, 8.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] And any information that I provide for you today will see will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh, and the total bill amount, please.
[CUSTOMER][NEUTRAL] $409 even 409.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And again, um, what was the total bill amount? I'm sorry, what was the total bill amount?
[CUSTOMER][NEUTRAL] 49409.
[AGENT][NEUTRAL] 409. Is that correct?
[CUSTOMER][NEUTRAL] That's fine, that's fine.
[CUSTOMER][NEUTRAL] 7:30 24449.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so this claim was received, [PII] received date was 10-28-2024.
[AGENT][NEUTRAL] It was processed on 10-31-2024.
[AGENT][NEUTRAL] The claim number is 352-358-8.
[AGENT][NEUTRAL] On this claim, there was a benefit paid in the amount of $1.56.
[AGENT][POSITIVE] And that check did clear.
[CUSTOMER][NEGATIVE] Just $1.56 no patient responsibility.
[AGENT][NEUTRAL] We do not determine patient responsibility, [PII]. Uh, we are not a major medical career. That would be up to the provider.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, you covered only the deductible, the co-pay was not covered.
[AGENT][NEUTRAL] Yes, and on this
[CUSTOMER][NEUTRAL] So the claim paid $1.56 no patient responsibility. Can I get that uh check number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We do
[AGENT][NEUTRAL] Yes, we do not determine that. The check number on this claim was 2011289 and it cleared on [PII].
[CUSTOMER][NEUTRAL] Uh, could you repeat that check number once more?
[AGENT][NEUTRAL] 2011289.
[CUSTOMER][NEUTRAL] 2011289
[AGENT][NEUTRAL] 2011289. Yes, sir.
[CUSTOMER][NEUTRAL] Is this a bulk or in a single chair?
[AGENT][NEUTRAL] Tango
[CUSTOMER][NEUTRAL] Mhm. And uh can I verify this provider's address on file?
[AGENT][NEUTRAL] You can go ahead.
[CUSTOMER][NEUTRAL] That's going to be [PII].
[AGENT][POSITIVE] Yes, so that is correct.
[CUSTOMER][NEUTRAL] And can I verify this patient's account number?
[AGENT][NEUTRAL] Did you say account number?
[CUSTOMER][NEUTRAL] Yes, which has V as in Victor in the middle.
[AGENT][NEUTRAL] OK, the account.
[CUSTOMER][NEUTRAL] Do you have the
[AGENT][NEUTRAL] Patient account number that was submitted. Mhm.
[CUSTOMER][NEUTRAL] 936
[CUSTOMER][NEUTRAL] That's 9366 uh sorry, that's 936-3358 [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Can I request you to send a copy of UP through fax or mail?
[AGENT][NEUTRAL] Can you access the internet because I also need to give you our website for our portal. We have a portalam which you can um create a username and password, and you should be able to also access this explanation of benefits. Our portal website is secured.
[CUSTOMER][NEUTRAL] OK. What's the code on it?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] That's secured, [PII] [PII] [PII] [PII]
[AGENT][NEUTRAL] 1 [PII] [PII] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]. OK, this can be. OK, call the on this one.
[AGENT][POSITIVE] Yes sir, that is correct.
[AGENT][POSITIVE] Yes, you would actually use my name, [PII], along with today's date.
[CUSTOMER][POSITIVE] Thank you so much. Have a great day. Happy weekend. Bye-bye.
[AGENT][POSITIVE] You are happy weekend to you as well, [PII], and thank you again for calling APL.