AccountId: 011433970860
ContactId: 15f3b8d6-53ff-41f4-9120-5183fa055bb9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 418570 ms
Total Talk Time (AGENT): 192141 ms
Total Talk Time (CUSTOMER): 160767 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/15f3b8d6-53ff-41f4-9120-5183fa055bb9_20250212T19:36_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I am not sure if I pressed the right button or not. I am calling from Good Samaritan Hospital in [PII].
[CUSTOMER][NEUTRAL] And I'm calling to follow up on a payment that your website that was made.
[AGENT][POSITIVE] OK. Well, yes, ma'am, you're in the right place. I can definitely help you with the claim status. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Do do do do do do 02517381.
[AGENT][POSITIVE] Thank you for that. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes. Oh.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you, and I didn't hear the first name.
[CUSTOMER][NEUTRAL] Oh [PII], I didn't hear. I just thought you said the last name and date of birth.
[AGENT][NEUTRAL] Oh, no, it's OK. Well, thank you for verifying and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the um date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, the data service is.
[CUSTOMER][NEUTRAL] 102 2024.
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] $19,530.95.
[AGENT][NEUTRAL] OK, here it is.
[AGENT][NEUTRAL] So I'm showing the claim was received on [PII].
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] And that claim number is 3541636.
[CUSTOMER][NEUTRAL] Oh wait a minute.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And um showing, hold on, let me get the check information.
[AGENT][NEUTRAL] Shall we process the payment on December or the claim on [PII]. I'm getting the check information now.
[CUSTOMER][NEUTRAL] Well, I have that because I was on your website.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEGATIVE] We have no record of receiving the payment.
[CUSTOMER][NEUTRAL] So I was wondering where it was sent.
[AGENT][NEUTRAL] Well, it so it's sent to [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, but it's still showing as outstanding. So I was just trying to pull up the check so I can see what the status was, but it's still showing as outstanding. So I can send this over to our representative and have her check on the check, and if it has in fact been cashed or, you know, cleared, she can provide a copy of the clear check. If not, we can go ahead and reissue this for you since it's been over 30 days.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the the check number is 2018518, is that correct?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And because that's what your EOB says, but if we don't have it, so now you're sending it where?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm sending it to our representative who handles the checks. Um, she's gonna check on the check status and see if it really has been cleared or if it um is outstanding. If it has been cleared, she'll provide a copy of the cleared check.
[AGENT][NEUTRAL] If it has not been cleared, then we'll go ahead and reissue it for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now
[CUSTOMER][NEUTRAL] How will I know?
[AGENT][NEUTRAL] How will you know?
[AGENT][NEUTRAL] That it's being processed.
[CUSTOMER][NEUTRAL] Whether it's cleared or not, is somebody gonna call me back? I mean, I don't have a record of it.
[AGENT][NEUTRAL] Right, so I'm sending her a request. Once she responds to me, I'll either have a copy of a check to send to you, or she's going to reissue the check and it will be mailed to you.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, like how will I know which one is happening? Are you gonna call me back or do I need to call you all back and how long does it normally take?
[AGENT][NEUTRAL] No, we're going
[AGENT][NEUTRAL] We'll reach out to you once we, once this request that I'm sending over, once she answers it, we'll reach out to you with the answer. So either she'll say it's cleared and provide me with the check for me to provide to you, or she'll say we'll need to reissue and she's going to reissue it and you'll receive the check in the mail. It's usually about a 7 to 10 business day turnaround.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, did I give you my direct line for you to call me?
[AGENT][NEUTRAL] Let me see. I have [PII].
[CUSTOMER][NEUTRAL] Yes, yes, now should because I.
[AGENT][NEUTRAL] Did you have a fax number?
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[CUSTOMER][NEUTRAL] [PII] attention [PII].
[AGENT][NEUTRAL] OK, and that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Well, I'll go ahead and um once I'll put this in the request so that once the um response is received, we'll fax it over to you or let you know the update.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, and you said it will take 7 to 10 business days?
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] OK, and is there a reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date, um, and that's [PII] The first initial to my last name is [PII], and then today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much for your help and you have a great day.
[AGENT][POSITIVE] Thank you, [PII]. You also, and thanks for calling [PII]. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] You're welcome bye bye.