AccountId: 011433970860
ContactId: 33f27860-851a-43b5-803c-ab81509468ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 404329 ms
Total Talk Time (AGENT): 120862 ms
Total Talk Time (CUSTOMER): 97239 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/33f27860-851a-43b5-803c-ab81509468ea_20250331T18:34_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, my name is, yes, I'm here. Uh, my name is [PII]. I'm calling from provider's office and looking for claim status.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you. OK, sure, [PII], I can assist you with claim status. Um, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] It's a medical claim.
[CUSTOMER][NEUTRAL] Yeah, sure. Just one moment.
[CUSTOMER][NEUTRAL] Yeah, callback number is [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] It's 023-41476.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Yeah, sure. Date of service is [PII] and the bill amount is $11,950 even. Could you please spell your name?
[AGENT][NEUTRAL] Um, it's spelled [PII].
[CUSTOMER][POSITIVE] Got it. Thank you so much.
[AGENT][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] OK. Yes, sir. We did receive that claim. We received that claim on.
[AGENT][NEUTRAL] We received the claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number is 3572381.
[AGENT][NEUTRAL] And the claim paid out for $1000.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, just one moment. What is the allowed amount?
[AGENT][NEUTRAL] The loud amount.
[AGENT][NEUTRAL] It was $2,339.38 but the claim only paid $1000 because under this policy, we only cover up to $1000 per calendar year for outpatient services.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] Just one moment.
[CUSTOMER][NEUTRAL] OK. The allowed amount was 2000. Am I right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, just one moment.
[CUSTOMER][NEUTRAL] Is there any patient responsibility?
[AGENT][NEUTRAL] No, I'm not showing any.
[CUSTOMER][NEUTRAL] OK, got it. Could you please fax it to us?
[AGENT][NEUTRAL] Yes, what's your fax number, please?
[CUSTOMER][NEUTRAL] Fax number is just one moment.
[CUSTOMER][NEUTRAL] Fax number is [PII].
[AGENT][NEUTRAL] So that's [PII].
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] Attention [PII].
[CUSTOMER][NEUTRAL] Attention user number 186-06859.
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] OK. I just faxed the um EOB to your office. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Just need call reference number.
[AGENT][NEUTRAL] Um, for the reference number.
[CUSTOMER][NEUTRAL] And one more thing, could you please
[CUSTOMER][NEUTRAL] Yeah, before call reference number, could you please provide the uh payment information? Like is it EFT or check?
[AGENT][NEUTRAL] It was a single check.
[AGENT][NEUTRAL] And the check number is.
[AGENT][NEUTRAL] 203-1327.
[CUSTOMER][NEUTRAL] 203
[AGENT][NEUTRAL] Yes, 1327.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Shingle check.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] What is the check issue date?
[AGENT][NEUTRAL] It was issued on.
[AGENT][NEUTRAL] Issued on [PII].
[CUSTOMER][NEUTRAL] Do you have any clear date?
[AGENT][NEUTRAL] No, I'm not showing it cleared yet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, please provide the reference number.
[AGENT][NEUTRAL] The reference number is my name and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got it. Thank you so much.
[AGENT][POSITIVE] OK, thank you, [PII], for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You, you too. Bye-bye.
[AGENT][POSITIVE] Mm, thank you.