AccountId: 011433970860
ContactId: 2d762a65-1abc-4a52-98ce-069f3fe564ed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 322970 ms
Total Talk Time (AGENT): 140414 ms
Total Talk Time (CUSTOMER): 130775 ms
Interruptions: 2
Overall Sentiment: AGENT=1.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/2d762a65-1abc-4a52-98ce-069f3fe564ed_20250218T13:50_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, this is [PII]. I want to check the claim status of a patient.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you with that claim status, [PII]. What is the callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] And it is 1066915.
[AGENT][NEUTRAL] Thank you, [PII] and the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you, and I'll be happy to assist you with that claim status. What is the data service?
[CUSTOMER][NEUTRAL] [PII], 2024. And the amount is 230.
[AGENT][NEUTRAL] And what is the name of this provider, the facility?
[CUSTOMER][NEUTRAL] Um, pediatric health questions.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I can help you with that claim status, [PII]. I'm showing that we received that claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was processed on [PII] and paid the maximum benefit of $25 for the office visit and that payment went to Pediatric Health of Weston.
[CUSTOMER][NEUTRAL] So there's only 227 or 25?
[AGENT][NEUTRAL] $25 we could pay toward that office visit copay.
[CUSTOMER][NEUTRAL] OK. Um, do you mind faxing the EOB to our fax number?
[AGENT][NEUTRAL] I can fax it
[CUSTOMER][NEUTRAL] Is this possible?
[AGENT][NEUTRAL] I can fax that for you, [PII]. Now, also we do have a provider portal where you have 24/7.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, yeah, I tried to register the parcel, but I couldn't be able to do it.
[AGENT][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Uh, did you have the patient's account number? Because I can assist you if you'd like, and that way you'll have that EOB on hand.
[CUSTOMER][NEUTRAL] Because.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I have but I don't have the insured SSN so it is required, I guess.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So when I give you the claim number, you can put it in that first option and the so the last four of the social is not required.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Um, that would be great.
[AGENT][POSITIVE] And I'll be happy to give you that claim number. Are you on our website?
[CUSTOMER][NEUTRAL] Um, just one second, please. I'm opening it right now. Um, the website is [PII], right?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Yes ma'am, that is correct.
[CUSTOMER][NEGATIVE] Uh, I just one more second. I logged in but I couldn't be able to.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] And the patient.
[CUSTOMER][POSITIVE] Yes, I'm ready.
[AGENT][NEUTRAL] The claim number is 356.
[AGENT][NEUTRAL] 1046.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then you'll just need her name and date of birth.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, just let me check that I can, whether I can be able to do or not.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Oh yeah. I, I, OK, thank you so much.
[AGENT][POSITIVE] That's a lot quicker than having to wait for it to be faxed, isn't it?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] No, you can take that one off your list.
[CUSTOMER][NEUTRAL] I tried so many ways.
[AGENT][POSITIVE] Yeah, if it doesn't pull up, you know, if you don't have the last 4, just call us, we'll be happy to provide that claim number.
[AGENT][NEUTRAL] And then you can just pull that EOB up instantly.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, so can I download the EOB?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is there an option? Yeah, OK. Uh, thank you so much. Um, do you have a do you have a call reference number?
[AGENT][POSITIVE] Yes ma'am. It'll be my name and today's date, and I spell my name [PII], first initial of my last name is [PII], and it was a pleasure to assist you with that claim status, [PII]. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Um, no, that's it. Thank you so much.
[AGENT][POSITIVE] My pleasure, [PII]. Thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.