AccountId: 011433970860
ContactId: 14479bd6-8af5-4812-9ccc-ac2234de36b2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 422089 ms
Total Talk Time (AGENT): 135680 ms
Total Talk Time (CUSTOMER): 183704 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/14479bd6-8af5-4812-9ccc-ac2234de36b2_20250204T15:54_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, this is [PII] at River Valley Primary Care Services, and I need to check claim status, um, about a claim.
[AGENT][NEUTRAL] OK, I can
[AGENT][NEUTRAL] OK, I can help you spell your first name, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh, that's my name. How I spell it as well.
[CUSTOMER][POSITIVE] Hey, hey, that's great and everybody else spells it wrong, huh?
[AGENT][POSITIVE] Exactly. We spell it the right way, exactly. What's the policy number, [PII]?
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It's gonna be D445-04748.
[AGENT][NEUTRAL] OK, do you have a card, a copy of the ID card?
[CUSTOMER][NEUTRAL] Uh let me look over here, bear with me just a second.
[AGENT][NEUTRAL] If you do,
[AGENT][NEUTRAL] Check to see if there's an outpatient policy er number that begins with a 0.
[CUSTOMER][NEUTRAL] OK, let's see here.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I have an employee ID. I have a group number.
[CUSTOMER][NEGATIVE] I don't see anything that begins with a 0.
[CUSTOMER][NEUTRAL] Uh, coverages plan provisions. Let's see here.
[CUSTOMER][NEUTRAL] Let me look at the back of the card and see if it.
[CUSTOMER][NEUTRAL] Give me anything.
[CUSTOMER][NEUTRAL] I don't see anything on there. It begins with a 01.
[AGENT][NEUTRAL] That's fine. Spell the patient's first and last name for me.
[CUSTOMER][NEUTRAL] OK, first name is [PII] Last name is [PII], [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what's a good phone number, [PII], in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And the patient's, uh, name?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] I'm sorry, you gave me that. Give me a second.
[CUSTOMER][POSITIVE] Not a problem.
[AGENT][NEUTRAL] Forgot I was supposed to be looking at the policy number.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Here we go, what's her date of birth?
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] And you are a medical provider?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you for verifying the information. I have the policy number. Let me know when you're ready.
[CUSTOMER][NEUTRAL] OK, I am ready. Uh, uh, let me, I called back on [PII] and I talked to [PII] and they said that they paid this claim. They paid it by check for $12 but I'm needing to find out, did that go to us or did it go to the member because we still have not received it.
[AGENT][NEUTRAL] Did she give you a claim number when you called?
[CUSTOMER][NEUTRAL] Uh, let me see here.
[CUSTOMER][NEGATIVE] No, she did not.
[AGENT][NEUTRAL] OK, what's the date of service in charge?
[CUSTOMER][NEUTRAL] OK, data service is gonna be 1120 $24 for $12.
[AGENT][NEUTRAL] OK. Is that for a lab?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now I show that the check was mailed to River Valley Primary Care. Can you verify your billing address for me?
[CUSTOMER][NEUTRAL] OK, uh, is it a PO box?
[CUSTOMER][NEUTRAL] Is that what they mailed it to was it a PO box or a physical?
[AGENT][NEUTRAL] What is your billing address?
[CUSTOMER][NEUTRAL] Uh, I've got [PII].
[AGENT][NEUTRAL] That's what we have. That's where the check was mailed, and I also showed that it cleared on [PII].
[CUSTOMER][NEUTRAL] OK, hold on just a second because I wanna write this down so it cleared on what day?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and can you tell was it Stamp River Valley on the back?
[AGENT][NEUTRAL] Um, I'll have to request a copy of the front and the back of the check and call you back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, let's say, so it cleared on [PII], uh, [PII], OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, alrighty, you got a reference number for me?
[AGENT][NEUTRAL] You'll use my name in today's state as your reference [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And first initial of last name is [PII], and is this a good call back number to return the call, uh, regarding the clear check [PII], is that your direct line?
[CUSTOMER][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, and my name is [PII] because there's another [PII] in here.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Oh, OK. [PII], OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] So we'll make that request and once um I receive a response I will give you a phone call.
[AGENT][NEUTRAL] And is there a fax number that I can send it to you?
[CUSTOMER][POSITIVE] OK, alrighty.
[CUSTOMER][NEUTRAL] Uh yes, it's uh [PII] and you can just put it in my attention.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. 479-431-20.
[AGENT][NEUTRAL] 2854.
[CUSTOMER][NEUTRAL] No 2054.
[AGENT][NEUTRAL] 02054 can't can't read my own handwriting, OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alrighty, so we'll, um, once we get a copy of it, I can fax it over but also call you and let you know that it was sent.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, thank you so much and you have a great day.
[AGENT][POSITIVE] You're welcome, [PII]. Anything else I can help out with today?
[CUSTOMER][NEUTRAL] That should be it.
[AGENT][POSITIVE] OK, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.