AccountId: 011433970860
ContactId: 0ce648b4-4be3-4062-9587-91c435606b41
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 426709 ms
Total Talk Time (AGENT): 95459 ms
Total Talk Time (CUSTOMER): 263296 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/0ce648b4-4be3-4062-9587-91c435606b41_20250424T19:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. This is [PII] calling from provide office. Um, can you help me with the claim status?
[AGENT][POSITIVE] Yes, I can help with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes it is um [PII].
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] OK, do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Policy number of the patient?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, it is, um, insured ID is 60801.
[CUSTOMER][NEUTRAL] And the group number is 23794. The group number is.
[AGENT][NEUTRAL] Um, that's um.
[AGENT][NEUTRAL] 23794.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 23794. Yes it is.
[AGENT][NEUTRAL] OK, and the patient's name?
[CUSTOMER][NEUTRAL] Uh, the last name is [PII], first name is [PII], and the date of birth is [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] 7790.
[AGENT][NEUTRAL] OK, and the date of service, pull them out.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII].
[CUSTOMER][NEUTRAL] And the charge amount is uh 1,128, 1128.
[CUSTOMER][NEUTRAL] Dollars
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like we received that claim on 12-20-2024.
[CUSTOMER][NEUTRAL] Wait, wait, I need to uh write it down.
[AGENT][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Uh you can go ahead now.
[AGENT][NEUTRAL] Claim was received 12-20-2024.
[AGENT][NEUTRAL] Processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You made a payment of $282.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You need the check number or?
[CUSTOMER][NEUTRAL] Paid amount is 282.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] May I know the allowed amount?
[AGENT][NEUTRAL] Um, this is a secondary policy, so there's not an allowed amount.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] OK. I can understand this, but, uh, even it is a secondary plan, uh, we do usually have uh a lot amount, right?
[AGENT][NEUTRAL] No, a loud amount is when there's a network.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] That's the primary.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sorry, the louder on this.
[AGENT][NEUTRAL] We, we just.
[AGENT][NEUTRAL] You don't have an allowed amount. You just process the claim according to the policy, what it pays.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This claim paid 282.
[CUSTOMER][NEUTRAL] OK. Is there any patient responsibility?
[AGENT][NEUTRAL] We're a secondary policy, so we don't determine patient responsibility.
[CUSTOMER][NEUTRAL] OK. Can I have the claim number?
[AGENT][NEUTRAL] 354-461-5
[CUSTOMER][NEUTRAL] Mhm. And uh can I know the, sorry, may I know the mode of payment?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was a single check.
[CUSTOMER][NEUTRAL] And the check number, please?
[AGENT][NEUTRAL] 2019945.
[CUSTOMER][NEUTRAL] OK, and pay to address for this check.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Are.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] We take care of
[CUSTOMER][NEUTRAL] Uh, can you please come again the ZIP code?
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK, what is it?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So does the uh claim uh paid on the same date as received, received it? No, it is paid on [PII]. Sorry, I missed it.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] I think.
[CUSTOMER][NEUTRAL] OK. Seems like I'm good to go. And can I have your call reference number?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That's just my name. My name is [PII] and then today's date.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Can I, can you spell your name?
[AGENT][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh thank you, [PII], for your assistance. Have a good day. Bye.
[AGENT][POSITIVE] And thank you for calling
[AGENT][POSITIVE] Thank you for calling APLU as well. Bye-bye.