AccountId: 011433970860
ContactId: 1efd5d43-5366-4dd3-a067-00333634772e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275279 ms
Total Talk Time (AGENT): 138489 ms
Total Talk Time (CUSTOMER): 98793 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/1efd5d43-5366-4dd3-a067-00333634772e_20250218T16:53_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is. How may I help you today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, hi, good morning. My name is [PII] calling from Helix Healthcare Services. I'm calling to check the status on the medical claim, and I'm sorry, what was your name?
[AGENT][NEUTRAL] My name is [PII] and your name was [PII]. Was that correct?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] [PII]. OK, [PII], thank you for that. Now go ahead and give me a good policy number, please, ma'am.
[CUSTOMER][NEUTRAL] Uh yes, the policy number. Oh great, hold on, bear with me. I have to check this out.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] It is AH 1805364. Wait, am I on the right patient?
[CUSTOMER][NEUTRAL] No, I'm not, bear with me. I'm sorry, I gave you the incorrect ID number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is 246-233-5.
[AGENT][NEUTRAL] All right, that sounds like a correct policy number, [PII]. OK, thank you for that information and while I'm pulling this up, go ahead and give me a good return telephone call number.
[CUSTOMER][NEUTRAL] [PII] and you said your name was [PII]? I'm sorry.
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][POSITIVE] Lovely. Thank you.
[AGENT][NEUTRAL] Yes, ma'am. All right, let's see. OK, what's your patient's name and date of birth this morning?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Well, looks like she is being insured on this medical supplemental plan, and you did say you want to check the status of a claim. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Total bill.
[CUSTOMER][NEUTRAL] $201.70.
[AGENT][NEUTRAL] Alright, let's see. Looks like we have your bill. Let's see.
[AGENT][NEUTRAL] Where is your bill from? What provider?
[CUSTOMER][NEUTRAL] Doctor [PII].
[AGENT][NEUTRAL] Yeah, looks like you're gonna be getting a check for $3.94. Let me see when this check printed right quick so we can see.
[CUSTOMER][NEUTRAL] For $3.94. So you guys don't cover the deductible? I mean, because I see here that there was a balance open for $106.63.
[AGENT][NEUTRAL] Yeah, the office visits are not covered here.
[CUSTOMER][NEUTRAL] Mm, that's all. Is it's.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yeah, it looks like, uh, you don't have time to receive the check. It is, yeah, you're gonna get a check for $30.94 and this check is dated [PII].
[CUSTOMER][NEUTRAL] OK, so it was a paper checks.
[AGENT][POSITIVE] It is a paper check and I'll be glad to give you the claim number as well as the check number, [PII], that would help you out.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Yes, ma'am. Your claim number is gonna be 355.
[AGENT][NEUTRAL] 1280.
[AGENT][NEUTRAL] And your check number is 2024312.
[CUSTOMER][NEUTRAL] OK, and let me ask you, being that you guys don't cover the office visits, that means that the patient will be held responsible for that balance.
[AGENT][NEGATIVE] It's not covered, it's not covered here.
[CUSTOMER][NEUTRAL] OK. And how can I get a copy of the EOB?
[AGENT][NEUTRAL] Yes
[AGENT][POSITIVE] I'll be glad to fax you one over if you want me to. [PII], give me a good fax number.
[CUSTOMER][POSITIVE] Yes, thank you so much. It is 786.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 322
[CUSTOMER][NEUTRAL] 5608.
[AGENT][NEUTRAL] Alright, let me repeat that fax and we'll make sure I'm writing this down, uh, correctly. It's area code [PII]. Was that the correct fax number?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, give me about 5 minutes and I'll get it faxed over to you, OK?
[CUSTOMER][POSITIVE] Yes, thank you so much.
[AGENT][POSITIVE] All right. Yes, ma'am. And is that all I can help you with today?
[CUSTOMER][NEUTRAL] Yes ma'am, do you provide reference numbers for the call?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, we don't, [PII], but you can use my name in today's date if you need to do so, OK?
[CUSTOMER][POSITIVE] Thank you, [PII]. You have a great day.
[AGENT][POSITIVE] You as well, [PII]. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.