AccountId: 011433970860
ContactId: 3f8bd667-3436-4ecb-9b2a-d5901936a3be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 488690 ms
Total Talk Time (AGENT): 184531 ms
Total Talk Time (CUSTOMER): 100170 ms
Interruptions: 3
Overall Sentiment: AGENT=1.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/3f8bd667-3436-4ecb-9b2a-d5901936a3be_20250415T12:19_UTC.wav
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[AGENT][NEUTRAL] Good morning thank you for calling APL. This is [PII]. How can I?
[CUSTOMER][NEUTRAL] Hey, good morning, [PII]. Uh, how are you doing? This is Ms. [PII] calling. Hey, [PII], this is Ms. [PII]. How are you?
[AGENT][NEUTRAL] Help you?
[AGENT][POSITIVE] I'm good, [PII]. How are you doing today?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Oh it's still early.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Um, can you tell me, I, it's still early. How you doing?
[AGENT][NEUTRAL] Yes, ma'am, it is.
[CUSTOMER][NEUTRAL] Yeah, I'm trying to get a claim status on a patient this morning.
[AGENT][POSITIVE] I'm all right
[AGENT][NEUTRAL] Uh yes.
[CUSTOMER][NEUTRAL] Yeah, I'm trying to, I'm trying to get a claim status this morning.
[AGENT][NEUTRAL] Sure, you need to get claims for one member.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, Ms. [PII], I think that there is a lag in our phone call. OK, I think there's a lag in our phone call and I'm so sorry about that, but I can't.
[CUSTOMER][NEUTRAL] Uh, for Jada [PII].
[AGENT][NEUTRAL] I can't fix it. So I'm sorry. So I can help you with your claim status. What is the member's policy of, well, first off, what is your callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII].
[CUSTOMER][NEUTRAL] 025951117.
[AGENT][NEUTRAL] OK, thank you, so give me just a couple of moments please to get the member's information pulled up.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Yes, ma'am. You're welcome.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name again and their date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's for [PII] Her date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and what is the date of serving total bill amount for her place?
[CUSTOMER][NEUTRAL] It's for [PII] for $590.46.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so just when this claim was received, it was 218.
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 356.
[AGENT][NEUTRAL] 6
[AGENT][NEUTRAL] 6967.
[AGENT][NEUTRAL] There was a $50 benefit paid on this claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it states with on the remark with this check, the maximum benefit payable for this state of service has been met.
[CUSTOMER][NEUTRAL] OK, so they didn't pay anything, right?
[AGENT][NEUTRAL] $50.
[CUSTOMER][NEUTRAL] $50. OK, that sounds good. OK. Now do did they mail out the EOB or can you fax it to me?
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh. Yes, ma'am.
[AGENT][NEUTRAL] I can give you our website in which you can print the EOB from now that you have the claim number, uh, but it was mailed along with the check.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, sounds good.
[AGENT][NEUTRAL] And that was checked. Do you need the check number? Do you need the
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, uh, the check number is 202.
[AGENT][NEUTRAL] 9152, and this was a single check.
[CUSTOMER][NEUTRAL] OK, and what's that website where I can get the EOP?
[AGENT][POSITIVE] And the website for our portal is secured.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] A
[AGENT][NEUTRAL] [PII] and if you will give me just a moment I'll go ahead and fax this one to you because.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I had already pulled that up, so bear with me just a moment.
[AGENT][NEUTRAL] It takes, it just takes a moment to be.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Will the fax need to have your name on it or is that not necessary?
[CUSTOMER][NEUTRAL] Yeah, you can put my name on it's my direct line [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so your phone number and fax number are the same?
[CUSTOMER][NEUTRAL] Mhm. Yes, ma'am.
[AGENT][NEUTRAL] Alright, just a moment.
[AGENT][NEUTRAL] Still loading.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and again, the phone number and fax number are both [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am. Mhm.
[AGENT][NEUTRAL] All right, well, I have just also sent you that um fax as well, the fax the EOB rather so it provided the.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] There's no technical mishap. You should be receiving that very soon.
[CUSTOMER][POSITIVE] OK. Thank you, Ms. [PII].
[CUSTOMER][POSITIVE] Have a good day.
[AGENT][POSITIVE] Well, you're welcome. Is there any, yeah, I hope you have a great day too, and thank you again for calling APL. Is that all I can help you with this morning?
[CUSTOMER][POSITIVE] Yes ma'am thank you I appreciate it.
[AGENT][POSITIVE] OK. Well, you're certainly welcome.
[CUSTOMER][NEUTRAL] Alright bye bye.
[AGENT][NEUTRAL] Bye-bye.