AccountId: 011433970860
ContactId: 34289fc2-7a89-4fa1-a68a-41c06b20f43b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 762030 ms
Total Talk Time (AGENT): 142701 ms
Total Talk Time (CUSTOMER): 155431 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/34289fc2-7a89-4fa1-a68a-41c06b20f43b_20250325T13:17_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I've got a provider on the line checking claim status, and I need to transfer this call if you don't mind.
[CUSTOMER][NEUTRAL] I do have policy number 60641.
[CUSTOMER][NEUTRAL] And the provider gave me claim number 353-2498.
[AGENT][NEUTRAL] I'm sorry, what was the policy number again?
[CUSTOMER][NEUTRAL] 650641 for [PII].
[AGENT][NEUTRAL] OK, and you said they were just needing claim status?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] They were, they gave me that claim number 353.
[CUSTOMER][NEUTRAL] 249 8.
[CUSTOMER][NEUTRAL] And it looks like it was paid to the I don't know why the provider has that claim number if it was paid to the insured.
[AGENT][NEUTRAL] OK, give me just a second.
[CUSTOMER][NEUTRAL] And he gave me the claim number.
[AGENT][NEUTRAL] OK, what was the name of the provider?
[CUSTOMER][NEUTRAL] His name is [PII] and I have his callback number as well.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Callback number is [PII]. I'm sorry, let me check that again. I'm sorry it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Thank you, [PII]. I appreciate it and I hope you have a wonderful day.
[AGENT][POSITIVE] Oh thanks you too.
[CUSTOMER][NEUTRAL] Let me get him on.
[CUSTOMER][NEUTRAL] [PII], I have [PII] on the line. She's going to assist you further.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Yes, thank you for holding how can I help you today?
[CUSTOMER][NEUTRAL] Um, sorry, I'm looking for a claim status.
[AGENT][NEUTRAL] OK, sure. Can I, can you verify the claim number or date of service for me, please?
[CUSTOMER][NEUTRAL] Claim number that I have is 3532498.
[AGENT][NEUTRAL] OK, let me take a look at that for you. Bear with me just a moment please.
[AGENT][NEUTRAL] OK, bear with me just a moment. I'm just taking a look here.
[AGENT][NEUTRAL] OK, yes, I do see that it looks like we received the claim on [PII] and it looks like it was processed and released on [PII]. Um, it looks like on the EOB, um, there wasn't a patient responsibility left to the provider, so the benefits were released to the insured.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I did not understand. Was, was there any payment on this claim?
[CUSTOMER][NEUTRAL] Or was it applied to the patient responsibility?
[AGENT][NEUTRAL] Uh, yes, so on the explanation of benefits that we received, there was not a patient responsibility, so the benefits were released to the insured.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Is there any allowed amount on this payment, uh, on this claim?
[AGENT][NEUTRAL] Um, it looks like the insurance had already paid in full, so there was no leftover responsibility to the patient.
[CUSTOMER][NEUTRAL] OK, let me check.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right. Can you provide me the EOP via fax?
[AGENT][NEUTRAL] Um, I can go ahead and give you, um, we have an online portal, um, that will show, um, the EOBs, and I can go ahead and give you that information.
[AGENT][NEUTRAL] Um, let me know whenever you're ready.
[CUSTOMER][NEUTRAL] Um, I think that would require the registration.
[AGENT][NEUTRAL] Right, so that we have an online service center for the providers, mhm, that we're able, you're able to get access to the EOBs.
[CUSTOMER][NEUTRAL] So it will be.
[CUSTOMER][NEUTRAL] Yes, uh, that's what I'm saying because that will require the registration as well.
[CUSTOMER][POSITIVE] Correct, so it will be uh much.
[AGENT][NEUTRAL] Um, uh, it, it doesn't have a registration. You, you would just, um, put in that you're a medical or dental provider and you would use the vendor number that you use on the claim. You don't have to register.
[CUSTOMER][NEUTRAL] What is the website?
[AGENT][POSITIVE] It is secured, [PII]
[AGENT][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] Secure. [PII].
[AGENT][NEUTRAL] And then
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] And on the um you just select that you're a medical or a dental provider and then it will just ask you information to pull up the claim.
[CUSTOMER][NEUTRAL] Can you repeat the name of the website?
[AGENT][NEUTRAL] It's secured. [PII].
[CUSTOMER][NEUTRAL] Yours
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Public
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It is asking for.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Username and password.
[AGENT][NEUTRAL] OK, did you select that you're a medical or dental provider?
[CUSTOMER][NEGATIVE] No it does not show that it is.
[CUSTOMER][NEUTRAL] Automatically asking for user name and ID.
[CUSTOMER][NEGATIVE] Maybe I'm on incorrect uh page.
[AGENT][NEUTRAL] OK, give me just a second.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, you would select if you're a new user you would select new user.
[CUSTOMER][NEUTRAL] So I
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] Do you see where it says new user?
[CUSTOMER][NEUTRAL] Uh, I can see claim status.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Checking
[AGENT][NEUTRAL] Oh, OK, you did you already log in, sir?
[CUSTOMER][NEUTRAL] Sign in our register.
[CUSTOMER][NEUTRAL] Find the provider.
[CUSTOMER][NEGATIVE] Uh, no.
[CUSTOMER][NEUTRAL] I have not logged in
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, so are you still at the page where it says it's asking for your username and password?
[CUSTOMER][NEUTRAL] I'm at
[CUSTOMER][NEUTRAL] Click claim status page inform claim. It is asking for sign in.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes it says new user.
[CUSTOMER][NEUTRAL] Hello?