AccountId: 011433970860
ContactId: 171bd4a7-def8-4803-a58f-e4ef3572e3f4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362140 ms
Total Talk Time (AGENT): 154729 ms
Total Talk Time (CUSTOMER): 157404 ms
Interruptions: 5
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/171bd4a7-def8-4803-a58f-e4ef3572e3f4_20250527T17:43_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey, this is [PII]. I have a provider's office on the line um checking claim status.
[AGENT][NEUTRAL] Sure, I, I can assist you with that. What is the policy number?
[CUSTOMER][NEUTRAL] 1,458,880
[AGENT][NEUTRAL] And what is the member's name and date of birth?
[CUSTOMER][NEUTRAL] And [PII], um, she verified the date of birth, but I don't remember. I'm going back. It was correct. Um, [PII]. She gave me that.
[AGENT][NEUTRAL] Mhm, that's fine.
[AGENT][NEUTRAL] And who's on the phone, um, [PII]?
[CUSTOMER][NEUTRAL] Her name is [PII].
[AGENT][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] And I do have a callback number.
[CUSTOMER][NEUTRAL] Uh
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Is the callback number the [PII] number?
[CUSTOMER][NEUTRAL] It is [PII], yeah, that's it. Yes.
[AGENT][NEUTRAL] You can send her over. Does she have, did she give you a date of service or no?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK thank you have a great day, [PII].
[CUSTOMER][POSITIVE] Right. You're welcome. You too. Here she comes.
[AGENT][POSITIVE] Thanks.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Hello [PII], how are you doing? Excuse me, my name is [PII] and I'll be assisting you. You're calling in.
[CUSTOMER][NEUTRAL] Hi, I'm fine.
[AGENT][NEUTRAL] You're calling about a claim for data service. I'm great, thanks for asking. [PII] said that you were calling about a claim for data service [PII]. Is this, is this claim the facility claim?
[CUSTOMER][POSITIVE] Yes. How are you today?
[CUSTOMER][NEUTRAL] Um, yes.
[CUSTOMER][NEUTRAL] From the Miami Cancer Institute. Yes, Baptist Hospital.
[AGENT][POSITIVE] Right. Thank you.
[AGENT][NEUTRAL] Looks like we received the claim [PII]. It was processed [PII], I mean [PII].
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It looks like there was a payment of $1377 made on this claim. Was the total bill amount $5100?
[CUSTOMER][NEUTRAL] Um, one second, let me go back over there. I didn't see, no, I didn't see. Are we talking about the same claim? It's for $15,100.
[AGENT][NEUTRAL] I'm not sure.
[AGENT][NEUTRAL] Right, and there was a payment of 11377.
[CUSTOMER][NEUTRAL] Um, we were looking for, I didn't see any payment on it.
[CUSTOMER][NEUTRAL] No, I didn't see any payment. Um, we're looking for a balance of 1,377. I did not see any payment on this claim.
[AGENT][NEUTRAL] Are you not able to hear me?
[CUSTOMER][NEUTRAL] 01 2nd.
[CUSTOMER][NEUTRAL] Hello, hello? Can you hear me?
[AGENT][NEUTRAL] Are you not able to hear me, [PII]?
[CUSTOMER][NEUTRAL] Yes, I'm hearing.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] OK, so you're calling about a claim.
[CUSTOMER][NEUTRAL] What happened here? Hello?
[AGENT][NEUTRAL] Yes, are you able to, OK, so I just asked you was the claim total bill amount $5100 and we made a payment of $1377.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So I'm not sure if you were able to I was providing you that information.
[CUSTOMER][NEUTRAL] OK, we didn't get when, when, when was that payment made?
[CUSTOMER][NEUTRAL] When was that payment made?
[AGENT][NEUTRAL] So it was processed [PII], so that means that the payment probably was made days later after that, but let me see.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let me see when it was submitted, when it, when it was cashed.
[CUSTOMER][NEUTRAL] I see something on the claim about I see some notes on the claim saying that um.
[CUSTOMER][NEGATIVE] My God, this stupid system.
[CUSTOMER][NEUTRAL] That's something about um requested information from patient was not received insurance request info from employer.
[AGENT][NEUTRAL] Is this from this from American Public life or this from someone else?
[AGENT][NEUTRAL] Because here in our system, this claim was processed and there was a payment of 1377 made on this on this claim.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] OK, I don't know where they are. Let me see where it's from. I didn't say what's your claim number on this claim, please?
[AGENT][NEUTRAL] 3549089
[CUSTOMER][NEUTRAL] Yes, it has to be from you. We have uh uh some kind of a note or correspondence it received from you guys. That's the claim number on here. It's dated [PII] and it says in insurance request info from employer.
[AGENT][NEGATIVE] Your phone is breaking up real, real bad, real bad.
[CUSTOMER][NEUTRAL] It's from you.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK. I'm so sorry. OK. I'll have to call you back then if you can't hear me good.
[AGENT][NEUTRAL] So this claim was processed [PII].
[AGENT][NEUTRAL] So that was, that was a month after what you're inquiring about.
[CUSTOMER][NEGATIVE] OK, we never got a payment. Where is the the payment sent to? What address?
[AGENT][NEUTRAL] Will be pending
[AGENT][NEUTRAL] I'm not sure if you, I'm not sure if you're on a speakerphone or what, but it's like you're muffling when you're talking.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Oh really? OK. I, I'll have to call you back then. Maybe I'm having problems with my phone.
[AGENT][NEUTRAL] Yes, and, and it's loud.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, so I can give you a call back. I have your callback number [PII]. That's your direct number, right? Is there an extension?
[CUSTOMER][NEUTRAL] I don't know what's wrong with my phone.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, yes, please. Thank you.
[AGENT][NEUTRAL] All right.