AccountId: 011433970860
ContactId: 19bb3302-0bde-45fa-a77b-d9453286258a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 434450 ms
Total Talk Time (AGENT): 113005 ms
Total Talk Time (CUSTOMER): 122677 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/19bb3302-0bde-45fa-a77b-d9453286258a_20250228T14:21_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Seven Hills OB GYN Associates.
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] [PII], direct line.
[AGENT][NEUTRAL] And do you have a policy number?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Do you have the policy number?
[CUSTOMER][NEUTRAL] Of member.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, it's uh D, D for Delta and the 437.
[AGENT][NEUTRAL] That's not one of our policy numbers. Do you have the social?
[CUSTOMER][NEUTRAL] Social number of the member.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, is this on a medical claim?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] And and what's her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were needing claim status?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I can look that up for you. What date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the procedure code for that claim?
[CUSTOMER][NEUTRAL] 76815.
[AGENT][NEUTRAL] OK, it looks like that claim was paid. We paid $75.
[CUSTOMER][NEUTRAL] $75. OK.
[CUSTOMER][NEUTRAL] When was it uh when was the claim paid?
[AGENT][NEUTRAL] Hold on just a moment, I'll check for you.
[AGENT][NEUTRAL] 213 of 25.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And uh what about the, is there any members liability?
[AGENT][NEUTRAL] Whatever is left over would be members responsibility.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Why it is member's responsibility.
[AGENT][NEUTRAL] Because that's the max we pay for that visit, $75.
[CUSTOMER][NEUTRAL] OK. Can I get the payment details, please?
[AGENT][NEUTRAL] The what now?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] I didn't understand your question.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Payment details.
[AGENT][NEUTRAL] What do you mean payment details?
[CUSTOMER][NEUTRAL] Yeah, it's a check number and that's a you can check or board shape and or else it is if it is EFT and the EFT number like that.
[AGENT][NEUTRAL] Paper check.
[AGENT][NEUTRAL] Check number 2027586.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] 2127586
[AGENT][NEUTRAL] 202-758-6.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] It's a paper check.
[AGENT][NEUTRAL] Paper check.
[CUSTOMER][NEUTRAL] OK. Is it in cash or outstanding?
[AGENT][NEGATIVE] Uh, you probably haven't had time to receive it. It was just paid on 213.
[CUSTOMER][NEUTRAL] OK. You don't have the details, sir.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] What other details would you like?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Is it in cash or or outstanding?
[AGENT][MIXED] It's still outstanding right now, but it hasn't been 30 days, so we can't do anything about it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. And can you give me the claim number which is paid?
[AGENT][NEUTRAL] 3559684.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is it single check or bulk check?
[AGENT][NEUTRAL] It's single check. We don't issue bulk checks.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. Can you also give me the effective date and time date of the member.
[AGENT][NEUTRAL] The effective date is [PII]. It is still active. It doesn't have a term date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And also, could you send the EOB through our fax number, please?
[AGENT][NEUTRAL] What's the fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'll fax it to you.
[CUSTOMER][NEUTRAL] Yeah, please.
[CUSTOMER][NEUTRAL] And also your good name?
[AGENT][NEUTRAL] I didn't hear you.
[CUSTOMER][NEUTRAL] The call reference number of this claim.
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] OK, [PII], thank you and have a great day.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day as well.
[CUSTOMER][NEUTRAL] Yeah