AccountId: 011433970860
ContactId: 1136ff7b-69b4-4faf-acc6-67227d265f53
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 507959 ms
Total Talk Time (AGENT): 145449 ms
Total Talk Time (CUSTOMER): 174504 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/1136ff7b-69b4-4faf-acc6-67227d265f53_20250610T18:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I have a question, uh, for my, you know, the claims that I did.
[CUSTOMER][NEUTRAL] And I need your help.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, do you have the claim number or policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me give you the.
[CUSTOMER][NEUTRAL] The outpatient number, um, it's 01842070 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] OK, give me just a second, let me pull this up here.
[AGENT][NEUTRAL] And then for security, I do need to verify please your name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And then lastly, I just need to verify your physical address and email, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then what would be the email on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. So is it the last claim that was filed on here under your name? Was it before that? Do you know the date?
[CUSTOMER][NEUTRAL] OK, so I wanna, I wanna go um.
[CUSTOMER][NEUTRAL] Last year and the year [PII].
[CUSTOMER][NEUTRAL] Can you tell me the 4?
[CUSTOMER][NEUTRAL] Specialist that you paid $50 to, please?
[CUSTOMER][NEUTRAL] Because they're saying that I had a follow up visit.
[CUSTOMER][NEUTRAL] In December I think it was and that I didn't pay the $60 but so I wanna know if the 4 were already exhausted by the time I went to that December visit, which is a probability, but I just need to verify.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Do you know what the date was that you were seen in December or?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] No, no, I wanted to know if the 4 had already been paid out. The 4 specialists that I get $50 credit for, I get 4 specialists a year that I get reimbursed $50. I want to know what those 4 specialists were, what those 4 checks were, the to the name of who?
[AGENT][NEUTRAL] Just, just.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Because I'm looking here in December and I don't see.
[CUSTOMER][NEGATIVE] They're just saying that in December that they put it through to you guys and it wasn't paid so I don't know what the service date is. I just, but if I already know that the 4 had been paid already earlier in the year, then I know that I didn't pay it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] So first one that I found is for 118 of 24 sports medicine associates.
[CUSTOMER][NEUTRAL] And that one was paid $50?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The next one is data service 4 22 24, same benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Provider reads as resa Azar and D.
[CUSTOMER][NEUTRAL] Oh, Azar. It's a cardiologist.
[AGENT][NEUTRAL] OK. Uh, then the next one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Looks like the next one is actually the same exact provider.
[CUSTOMER][NEUTRAL] Really?
[AGENT][NEUTRAL] Yeah, but let me double check this. Let me check.
[CUSTOMER][NEUTRAL] I don't remember going back to him again after that one.
[AGENT][NEUTRAL] Let me go back and double check. OK.
[AGENT][NEUTRAL] 12.
[AGENT][NEUTRAL] OK, so first one was the sports medicine associates, then the next one was the cardiologist that you had stated. Then the next one comes up.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, as a date of service [PII], that was also sports medicine associate.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Then
[CUSTOMER][NEUTRAL] I, uh, I'll take, yes, OK.
[AGENT][NEUTRAL] And then the next one.
[AGENT][NEUTRAL] Sports medicine associates and data service was [PII] of 24.
[CUSTOMER][NEUTRAL] OK, and what that was.
[CUSTOMER][NEUTRAL] You're saying uh 8:14?
[AGENT][NEUTRAL] Mhm. It says [PII] of 24. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that was sports medicine?
[AGENT][NEUTRAL] Uh-huh, yes ma'am.
[CUSTOMER][NEUTRAL] No, that's Doctor, yeah.
[CUSTOMER][NEUTRAL] Spose
[CUSTOMER][NEUTRAL] That was $50.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, I guess not. I guess I didn't.
[CUSTOMER][NEUTRAL] Do you have any other claims sent in for sports medicine, um.
[CUSTOMER][NEGATIVE] For that year that was denied because they already had been paid, do you have the stuff that maybe.
[AGENT][NEUTRAL] Um, for 202 for 2024 there was a claim oh that was something different, one moment.
[CUSTOMER][NEUTRAL] I don't know when I went again.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] The only other thing that I see for 2024 is it looks like a provider under the name South Florida Spine and Sports.
[CUSTOMER][NEUTRAL] Yes, that one. What, what date was that? Because that's the one I think they're probably saying I didn't pay.
[AGENT][NEUTRAL] So there.
[AGENT][NEUTRAL] There's one for [PII] of 24.
[CUSTOMER][NEUTRAL] 1:14 and it is my calendar.
[AGENT][NEUTRAL] And [PII].
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] I paid with my Visa.
[CUSTOMER][NEUTRAL] And then on the other one is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I paid that one with my Visa also.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Visa and Visa.
[CUSTOMER][NEUTRAL] OK, no, that's um
[CUSTOMER][NEUTRAL] That's it. They're
[CUSTOMER][NEUTRAL] I think they're saying I didn't pay, but I have that I paid with my credit card.
[CUSTOMER][POSITIVE] OK all right thank you so much for your help.
[AGENT][POSITIVE] You're welcome. Anything else I can check on for you?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] Oh, you're welcome. Have a good day.
[CUSTOMER][POSITIVE] OK, thanks