AccountId: 011433970860
ContactId: 21f90246-a1ab-426e-aa5f-a71e63cfe67c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 330950 ms
Total Talk Time (AGENT): 118620 ms
Total Talk Time (CUSTOMER): 135225 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/21f90246-a1ab-426e-aa5f-a71e63cfe67c_20250502T19:23_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 from the office, DJ Samsung Community Hospital. I'm looking for the claim status, one of my members who is, you know, associated with the American Life Insurance. So, would you please help me with the status of the claim? So I'm looking for the claim status in the provider line. I got your number. What is the.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I can verify claim status for you and you say your name is [PII]?
[CUSTOMER][POSITIVE] Yes, you're right.
[AGENT][NEUTRAL] OK, and what is that policy number, please?
[CUSTOMER][NEUTRAL] It's gonna be 0256.
[CUSTOMER][NEUTRAL] 7172.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you, and give me a moment.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh, I'm sorry, I didn't catch your name. Can you please spell it for me?
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Last initial [PII] and [PII], verify the patient's, you're welcome, verify the patient's name, date of birth.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII], spells like the first name, [PII].
[CUSTOMER][NEUTRAL] The last name is [PII]. It's like [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] [PII] $2024 amount, $530 even.
[CUSTOMER][NEUTRAL] 530 even.
[AGENT][NEUTRAL] OK thank you one moment please.
[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 EOB. That site is at [PII].
[CUSTOMER][POSITIVE] Mm, secure. [PII].
[AGENT][POSITIVE] [PII], correct.
[AGENT][NEUTRAL] And what's the name of the office you're calling from?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's TJ Samson. It's T for Tango, J for Juliet, Samson Community Hospital.
[AGENT][NEUTRAL] I see TJ Sampson Oncology Clinic.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I'll provide the tax ID so it starts with the TJ only.
[CUSTOMER][NEUTRAL] OK. So, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm showing that claim paid $50 and that was on me.
[CUSTOMER][NEUTRAL] Uh, just a second, sorry to interrupt you. Uh, can you please go with the received date and when it was received process, how much it was allowed and paid for by the queue.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Claim received [PII], processed on [PII] and a check was mailed in the amount of $50.
[CUSTOMER][NEUTRAL] $50.
[CUSTOMER][NEUTRAL] Just a second, bear with me.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Um, there is, uh, actually it was billed as $530 with the, it was paid all the CPT so what is anything was left, uh.
[CUSTOMER][NEGATIVE] Oh, denied or something.
[AGENT][NEUTRAL] Well, for the patient's policy is an indemnity plan and for an office visit, the max we pay is $50 so that's the max that was payable.
[CUSTOMER][NEUTRAL] Mm, OK, it was a single check, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Can I have the check number?
[AGENT][NEUTRAL] 2018818
[CUSTOMER][NEUTRAL] Mm, do you have a copy of COB?
[AGENT][NEUTRAL] As I stated previously, we do have an online service center where providers can check claim status as well as print out the EOB. That site is at secured. AM [PII].
[CUSTOMER][NEUTRAL] Can you please send the fax to us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] He is
[CUSTOMER][NEUTRAL] Mm, that's all for today. OK. Yeah. Can I have the reference number for the call today?
[AGENT][POSITIVE] OK, uh thank you for.
[AGENT][NEUTRAL] Uh, you may use my name at today's date if you like.
[CUSTOMER][POSITIVE] OK, that's all for today. OK. Thanks for assisting me. Have a nice day. Bye for now.
[AGENT][POSITIVE] Alright, you're welcome. Thank you for calling APL.
[AGENT][NEUTRAL] Bye.