AccountId: 011433970860
ContactId: 3cd48bde-cd36-4d4c-8491-394f875ad62c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 267769 ms
Total Talk Time (AGENT): 112849 ms
Total Talk Time (CUSTOMER): 103258 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/3cd48bde-cd36-4d4c-8491-394f875ad62c_20250425T17:11_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, um, yes, my name is [PII], excuse me, and I'm calling from Variety Care. I was calling to, um, get the status on a claim.
[AGENT][NEUTRAL] Sure, I can assist you with that. Could you provide me with the spelling of your name?
[CUSTOMER][NEUTRAL] It is [PII]
[AGENT][POSITIVE] And what's the call back number for you and that policy number [PII] and I'll be able to assist you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, the policy number is 02570313.
[AGENT][NEUTRAL] Could you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what this is for medical, correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What is the date of service?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Procedure code of 99213.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] 963 you're calling to check the status of this claim which was received [PII]. It was processed [PII], which it was yesterday.
[AGENT][NEUTRAL] Let me give you that claim number and the check number. Let me know when you're ready for it.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] 359-096-3 is the claim number.
[AGENT][NEUTRAL] There was a payment of $50 made on this claim?
[AGENT][NEUTRAL] Check number is 204-0983. Were there multiple procedure codes?
[CUSTOMER][NEGATIVE] It is, but they, they don't.
[AGENT][NEUTRAL] Right, OK. I just wanted to make sure cause when I opened it up there was multiple procedure codes.
[CUSTOMER][NEUTRAL] Have any amount on them.
[AGENT][NEUTRAL] Make sure I hit the right claim with the check number is 204-0983.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] OK, and you said 50 or 65 or 6?
[AGENT][NEUTRAL] 50.
[AGENT][NEUTRAL] It looks like the member's benefit amount is $50 per visit.
[CUSTOMER][POSITIVE] I'm, I'm sorry.
[CUSTOMER][NEUTRAL] OK, 50 per visit.
[AGENT][NEGATIVE] My speech impairment on that country.
[CUSTOMER][NEUTRAL] No, no, when you, when you repeated it, it was like a number was pressed, so we just like I didn't hear none of it.
[AGENT][NEUTRAL] Got you. Oh, I know I'm kind, but I know.
[CUSTOMER][NEGATIVE] No, no.
[CUSTOMER][NEUTRAL] No, I'm just trying to make sure I'm I'm hearing it right so we know, um.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEGATIVE] And uh let me see what this is no pay.
[CUSTOMER][NEUTRAL] Paper you'll be.
[CUSTOMER][NEUTRAL] And you is was this is so with a check, but where did what address did it go to if you have that information?
[AGENT][NEUTRAL] So this check was just, this claim was just processed yesterday.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Yeah, that, that's why I'm a little confused. You see in this process yesterday, but we have the claim, but we have a denial with that claim number, so that's why I was trying to figure out.
[AGENT][NEUTRAL] So they probably was.
[AGENT][NEUTRAL] It was pending then and then it was released because the requested information that came in that's probably why it's that way. So we probably received the the um the eligibility verification yesterday and that's why it was processed yesterday and released. So this claim, the check was sent to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, yeah, that's perfect, OK.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Just the reference number.
[AGENT][NEUTRAL] We don't provide those unfortunately you can use my name in today's date as a reference.
[CUSTOMER][NEUTRAL] And can you repeat your name for me?
[AGENT][NEUTRAL] Mhm. My name is [PII], and today's date is a reference.
[CUSTOMER][POSITIVE] OK, that is all I needed thank you ma'am.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a good day. Goodbye.
[CUSTOMER][NEUTRAL] You too. Bye bye.