AccountId: 011433970860
ContactId: 2aba669f-7ef0-4f33-b970-660adbd11982
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1214579 ms
Total Talk Time (AGENT): 281587 ms
Total Talk Time (CUSTOMER): 267173 ms
Interruptions: 6
Overall Sentiment: AGENT=1.7, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/2aba669f-7ef0-4f33-b970-660adbd11982_20250108T13:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh hello, [PII]. My name is [PII] calling from provider's office in order to check a medical claims. Could you please assist me with that?
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]. There's no extension, it's a direction, it's a direct line. I do apologize.
[AGENT][NEUTRAL] OK, thank you. That's OK. And how many claims, [PII], do you have to check claim status on?
[CUSTOMER][NEUTRAL] I'm just having 2 claims.
[AGENT][NEUTRAL] For the same patient or different patients?
[CUSTOMER][NEUTRAL] And before proceeding,
[CUSTOMER][NEUTRAL] Uh, actually, I have to check, uh, for that. But before providing that information, I do apologize that actually I didn't catch your name. I do apologize without catching your name, I'm speaking with you. Could I please get your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Uh, actually, you're saying [PII], right? It's [PII], that's what I need clarity.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Perfect. So, I don't want to misspell your name, so that's for the reason. I just reconfirmed. Thank you so much.
[AGENT][NEUTRAL] OK. Sure, you're welcome. And so [PII], you will actually use my name along with today's date as each reference call reference number. Also, any information that I provide for you on the claims today will be a verification of benefits and not a guarantee of payment. And lastly, if you need a copy, if we do have the claim on file and you need a copy of the EOB, you can get that from our portal by going to secured.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Is there any registration required for that?
[AGENT][NEUTRAL] You would set up your own username and password. Yes, ma'am, you will need to register.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Perfect. Thank you.
[AGENT][NEUTRAL] You're welcome. And what is the first patient's policy number?
[CUSTOMER][NEUTRAL] Um, yeah. The first patient policy number was 02509981.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Oh, sure.
[AGENT][NEUTRAL] And the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] Well, the member's name is uh
[CUSTOMER][NEUTRAL] [PII], for the birth date [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Day of service and total bill amount.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] The service date was [PII] with the total bill amount of $21 even.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and you said that the total bill amount is $21 is that correct?
[CUSTOMER][POSITIVE] Yeah, that is correct.
[AGENT][NEUTRAL] OK, give me one moment to look at one more thing.
[CUSTOMER][POSITIVE] Yeah, please take your time no rush.
[AGENT][NEUTRAL] OK, so this claim was received. The received date was [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 3511011.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $3.78.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That was paid on single check. Mhm.
[CUSTOMER][NEUTRAL] So, could you please uh confirm me?
[CUSTOMER][NEUTRAL] The claim number is 3511011. Am I correct?
[AGENT][NEUTRAL] That is correct. And what is the address for mailing? Mhm. And what is the mailing address for the payment?
[CUSTOMER][POSITIVE] Perfect. Thank you so much.
[CUSTOMER][NEUTRAL] All right, just give me a moment. Let me verify that information.
[CUSTOMER][NEUTRAL] It's [PII] with the ZIP code [PII].
[AGENT][NEUTRAL] OK, that is not the address that we received on the claim for payment to be mailed to.
[CUSTOMER][NEUTRAL] All right. I do have two more addresses because we have uh three addresses on file. And the other one is [PII] with the ZIP code [PII].
[AGENT][NEUTRAL] Yes, ma'am. That is where that was mailed.
[CUSTOMER][POSITIVE] Perfect. Thank you so much. And uh may I have the check or EFT number, how the mode of payment was done?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Single check, check number 2004992.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK. When it was issued?
[AGENT][POSITIVE] It was issued on [PII] and this check does still show as outstanding.
[CUSTOMER][NEUTRAL] OK. So still the check was not cashed yet, right?
[AGENT][NEUTRAL] Not as of now, no, ma'am.
[CUSTOMER][NEUTRAL] OK. How much time it will take to uh cash the check?
[AGENT][NEUTRAL] I, I can't answer that. You would have to contact that office.
[CUSTOMER][NEUTRAL] All right. Is there any possibility to reissue the check?
[AGENT][NEUTRAL] I can request.
[CUSTOMER][NEUTRAL] Because it was already cross infected. Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I can request the verification that the check has not been cashed.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And request to reissue.
[AGENT][NEUTRAL] It's going to take me a few moments to make that request.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So do you mind waiting while I do that?
[CUSTOMER][POSITIVE] Yeah, sure. Please take your time. No problem.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] It just takes a few moments to thank you for your patience, [PII], and me submitting this request to have it verified.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Ah, you're welcome.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, as you said, the call reference number is your name and today's date. Am I right?
[AGENT][NEUTRAL] Uh, yes, ma'am.
[CUSTOMER][NEUTRAL] OK. Just give me a moment, please. Let me grab the next member's information here.
[AGENT][NEUTRAL] Yes, ma'am. I'm not ready yet. It's gonna take me several minutes to do this request for this check, so that's fine.
[CUSTOMER][NEUTRAL] All right. Yeah, yeah, please proceed. Yeah, please. Yeah.
[AGENT][NEUTRAL] And I am still here, [PII], I'm still working on this.
[CUSTOMER][NEUTRAL] Yeah, yeah, please proceed.
[AGENT][NEUTRAL] OK, so I'm ready for the next member's policy number.
[CUSTOMER][NEUTRAL] Yes, I'm I'm here just give me a moment please, since it was a hold, I just closed the account. Thank you one moment please.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Uh, for patient with, yeah, here we go with the.
[AGENT][POSITIVE] Yes ma'am. I appreciate your patience as well.
[CUSTOMER][POSITIVE] Thank you. Yeah, here we go with the next one. And it was a different number?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the member ID for this one.
[CUSTOMER][NEUTRAL] It's 02501560. M [PII] as in [PII], number [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Mhm. You're welcome.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh well, the member's name, just a moment please, let me grab.
[AGENT][NEUTRAL] Patient yes, patient name and date of birth, uh-huh.
[CUSTOMER][NEUTRAL] Yes. Well, the patient's name is [PII]. For the birth date of [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Well, bear with me. I'm having some difficulty with one of my screens. Just one moment, please.
[CUSTOMER][POSITIVE] Yeah, yeah. Please take your time. No rush. It will happen.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, I have to love technology sometimes.
[CUSTOMER][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her, please?
[CUSTOMER][NEUTRAL] Uh, for the service date, it was [PII], with the total charge amount of $1,279 even.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][POSITIVE] Yeah, please take your time.
[AGENT][NEUTRAL] OK, so this claim was also received. It was received on 12-13-2024.
[AGENT][NEUTRAL] Processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 3541614.
[AGENT][POSITIVE] There was a benefit paid in the amount.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] Of $626.20.
[AGENT][NEUTRAL] That was paid on single check.
[CUSTOMER][NEUTRAL] You're in an
[AGENT][NEUTRAL] 20
[CUSTOMER][NEUTRAL] You're in and out to me. I apologize. Uh, so you said that how much amount you uh have been made a payment? Is that 626?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 0.22.
[CUSTOMER][POSITIVE] OK. 626.22. OK, perfect. Um
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes. May I have the payment details, please?
[AGENT][NEUTRAL] Uh, the payment was issued on [PII].
[AGENT][NEUTRAL] Single check, 2018554.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mailed to that same address.
[AGENT][POSITIVE] And it is still showing as outstanding.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Mm.
[CUSTOMER][POSITIVE] As it was issued recently, uh, it may take time, uh, fine. Yup, thank you so much. Uh.
[AGENT][NEUTRAL] Uh, yes, ma'am.
[CUSTOMER][POSITIVE] Yeah, thank you so much for all your assistance. Hope you have a very wonderful day.
[AGENT][POSITIVE] Well, you're very welcome.
[AGENT][POSITIVE] Yes, ma'am. Thank you. OK. And I hope you have a nice day as well, [PII]. Is that all I can help you with this morning?
[CUSTOMER][NEUTRAL] Yeah. Bye for now.
[CUSTOMER][POSITIVE] Yes, done. Everything was done. Thank you so much.
[AGENT][POSITIVE] OK, well, you're very welcome and thank you again for calling APL and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][POSITIVE] Um, thank you