AccountId: 011433970860
ContactId: 2953882c-e5e7-46ba-848d-11828349b10b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 237350 ms
Total Talk Time (AGENT): 81261 ms
Total Talk Time (CUSTOMER): 69716 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/2953882c-e5e7-46ba-848d-11828349b10b_20250421T18:34_UTC.wav
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[AGENT][NEUTRAL] Thanks for calling APL. This is [PII] may I assist you?
[CUSTOMER][NEUTRAL] Uh, hi [PII]. This is [PII] from office. I'm looking for the claim status.
[AGENT][POSITIVE] Sure, I can assist you with that.
[AGENT][NEUTRAL] Can I have your callback number and the spelling of your name?
[CUSTOMER][NEUTRAL] Sure, my name spells like [PII], and the callback number it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII]. You said your name was [PII]? Pronounce your name for me.
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] [PII], thank you [PII]. Can I have that policy number, the member that you're calling to verify benefits for?
[CUSTOMER][NEUTRAL] Yeah, sure. So the, uh, policy number is 018412777.
[AGENT][NEUTRAL] Could you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII] with the date of birth of [PII].
[AGENT][NEUTRAL] Thank you and you're calling to verify benefits and eligibility?
[CUSTOMER][NEUTRAL] Claim status.
[AGENT][NEUTRAL] Status of the claim, I apologize. What's the date of service that you call and check the status of the claim for?
[CUSTOMER][NEUTRAL] It's uh [PII] charge amount uh have uh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, [PII] [PII].
[AGENT][NEUTRAL] And what is your first procedure code?
[CUSTOMER][NEUTRAL] Uh, so the first procedure code is 87,030.
[AGENT][POSITIVE] Thank you. 92.
[AGENT][NEUTRAL] 332.
[AGENT][NEUTRAL] 9332.
[AGENT][NEUTRAL] This claim was submitted on [PII]. It was processed [PII]. There was no payments made on this claim, and the reason why there was no payment made on this claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's because the benefits were applied towards the deductible. The member has a $250 yearly deductible amount.
[CUSTOMER][NEUTRAL] Uh, when this claim was processed on January.
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] The full amount which is 89.3%.
[CUSTOMER][NEUTRAL] went towards
[CUSTOMER][NEUTRAL] Patient responsibility, right?
[AGENT][NEUTRAL] Yes, the member's $250 went towards the deductible amount.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Claim number, please.
[AGENT][NEUTRAL] Claim number is 354-9332. That's 3549332.
[CUSTOMER][NEUTRAL] And where we can get the UV?
[AGENT][NEUTRAL] Repeat yourself.
[CUSTOMER][NEUTRAL] Uh, where I can get the UB please?
[AGENT][NEUTRAL] You can go online to [PII] [PII]. However, I can send you a fax of it. Would you like for me to send you a fax of the ELB?
[CUSTOMER][NEUTRAL] OK. I'll check from the portal.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, that's it.
[AGENT][POSITIVE] Thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] This is the information I was looking for.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thanks. Goodbye.