AccountId: 011433970860
ContactId: 16cd5564-073a-434b-90c3-b564861b2625
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 369549 ms
Total Talk Time (AGENT): 99744 ms
Total Talk Time (CUSTOMER): 142433 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/16cd5564-073a-434b-90c3-b564861b2625_20250220T20:05_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling for the provider to check on claims.
[AGENT][NEUTRAL] OK, I can verify claim status for you. And [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Uh, the policy number is 02539176.
[AGENT][NEUTRAL] 9176. OK. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh yes.
[CUSTOMER][NEUTRAL] Uh, the callback number is [PII].
[AGENT][NEUTRAL] And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] I think
[CUSTOMER][NEUTRAL] Uh, the patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Uh, so these details, give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] and the total bill amount is 1 $605.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, hold on one moment, please.
[CUSTOMER][NEUTRAL] OK, yeah sure.
[CUSTOMER][POSITIVE] Mission accomplishment.
[AGENT][NEUTRAL] Uh, you said [PII]?
[CUSTOMER][POSITIVE] Uh, yes, that's correct.
[AGENT][NEUTRAL] [PII]. 1 moment.
[AGENT][NEUTRAL] And the name of the provider's office?
[CUSTOMER][NEUTRAL] Uh, the provider office name is Emergency physicians Associates.
[AGENT][NEUTRAL] OK, and while I'm looking at claim information let you know we do have an online service center where providers can check claim status as well as print out the ELB. That site is at [PII] and I'm showing on this claim we paid $100 which might benefit for this data service.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] So you have paid for this claim?
[AGENT][POSITIVE] We paid $100 and with this payment it matched the benefits for the data service.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Give me a moment. Let me take a note on that. Just a moment, please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Come on.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I I
[CUSTOMER][NEUTRAL] Sorry, could you repeat your name, please?
[AGENT][NEUTRAL] It's [PII], last initial [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Uh, so [PII], um, you mentioned you have paid for this claim, right? Is there any other detail on this claim because here it shows the bill amount is $605 but you have paid only $100.
[AGENT][NEUTRAL] Because for the patient's policy, that is the max benefit payable for this ER visit is 100.
[CUSTOMER][NEUTRAL] OK. Allowed and paid.
[CUSTOMER][NEUTRAL] OK. Allowed and paid this $100 right? You have paid uh as per your allowed amount, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Just a moment. Let me take a note on that.
[CUSTOMER][NEUTRAL] Is there any only $100 even or any?
[AGENT][NEUTRAL] $100 even.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, can I get the check number for that?
[AGENT][NEUTRAL] 202-5782
[CUSTOMER][NEUTRAL] OK. Uh, may I know when was it paid?
[AGENT][NEUTRAL] A check was issued on [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, all right. Is there, uh, may I know the cash date when was it cashed?
[AGENT][NEGATIVE] I don't show that it's cleared.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have the bank account information?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Do you have the bulk amount information?
[AGENT][NEUTRAL] It was $100. It's a single check, single payment check of $100.
[CUSTOMER][NEUTRAL] Is that a bulk or a single payment?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] All right. Can I get the claim number?
[AGENT][NEUTRAL] 3558631.
[CUSTOMER][NEUTRAL] Government's number?
[AGENT][NEUTRAL] We don't give reference numbers, you may use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. So thank you for the information, [PII].
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] It is
[AGENT][NEUTRAL] Bye.