AccountId: 011433970860
ContactId: 36cc9abd-e92b-4e8d-aa12-e3f6035bfa23
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256709 ms
Total Talk Time (AGENT): 134796 ms
Total Talk Time (CUSTOMER): 68475 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/36cc9abd-e92b-4e8d-aa12-e3f6035bfa23_20250210T22:20_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling from uh Franciscan physician Network, and I'm calling to check the status of a payment on a claim for a patient of ours.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the claim status. And [PII], may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and the policy number is 2505449.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], uh, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the data service for the claim you'd like me to check on?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. Billed amount was $280.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] Here it is.
[AGENT][NEUTRAL] And that was [PII] $280.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, this is it.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] So I'm showing the claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Claim number is 3549212.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], the claim was paid out on a total of $50 to the provider.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you need that check information?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So with a single check um in the amount of $50 check number 202.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 1891.
[AGENT][POSITIVE] And it was issued on [PII]. It's still outstanding.
[CUSTOMER][NEUTRAL] OK, do you show where it was mailed?
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] Mhm, yeah, OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, that's correct because we're not showing mhm go ahead.
[AGENT][NEUTRAL] Now, since it is
[AGENT][NEUTRAL] Oh, since it is over 30 days, I can send this over to have [PII] check on the check and um see if it has truly cleared if it has, we can provide you with a copy of the check, but if not, we can reissue and have it resent to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that would be good because we haven't on our end we're not showing that we received it, yeah.
[AGENT][NEUTRAL] You wanna do that?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So we usually say for that to give it about the 77 to 10 business days to get corrected and, you know, get the the, well not the decision, but the findings, um, and then we'll either provide you with the check or the, well, the clear check or your new check.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] OK alright sounds good and for my notes again your name is?
[AGENT][NEUTRAL] Mhm. My name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] First initial to my last.
[CUSTOMER][NEUTRAL] OK, and do you give reference numbers?
[AGENT][NEUTRAL] Um, there's no call reference number, but you can use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you very much.
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Nope, that's it.
[AGENT][POSITIVE] All right, thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] Thank you, bye bye.