AccountId: 011433970860
ContactId: 40f355f2-1166-4e26-a740-1832b36ea542
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 331450 ms
Total Talk Time (AGENT): 132345 ms
Total Talk Time (CUSTOMER): 78286 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/40f355f2-1166-4e26-a740-1832b36ea542_20250617T13:02_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling for claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII]. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Just one.
[AGENT][NEUTRAL] And may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Um, so direct line [PII].
[CUSTOMER][NEUTRAL] Policy number is D for Danny 43732965.
[AGENT][NEUTRAL] Thank you for that. And do you have a copy of the member's ID card available?
[CUSTOMER][NEUTRAL] Yes, let me pull it up.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] APL. OK, I have it.
[AGENT][NEUTRAL] OK, so we're looking for the in-hospital or outpatient policy cert number?
[AGENT][NEUTRAL] It should start with a 01 or 02.
[CUSTOMER][NEUTRAL] OK, 02603543.
[AGENT][NEUTRAL] Thank you. Hold on one moment. Now that the number that you gave, that's for 90 degree benefits, this number here is their APO policy number.
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][NEUTRAL] Welcome. I'm waiting for it to come up now. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII], I might pronounce that incorrectly. Last name is [PII]. Birthday is [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 date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] Data service is for [PII]. Total charge is $420.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] I believe I located it. I'm waiting for it to come up now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Piedmont [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] 4:[PII].
[AGENT][NEUTRAL] Alright, just found it. So I'm showing that the claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 358.
[AGENT][NEUTRAL] 8393.
[AGENT][NEUTRAL] And on [PII], the claim was paid out on to the provider.
[AGENT][NEUTRAL] A total of $75.
[AGENT][NEUTRAL] Did you need the check information?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Alright, hold on one moment.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Um, so it was a single check.
[AGENT][NEUTRAL] The check number is 203.
[AGENT][NEUTRAL] 854 4.
[AGENT][NEUTRAL] It was mailed to [PII].
[CUSTOMER][NEUTRAL] Yes, that's correct. Do you have a
[AGENT][NEUTRAL] It was issued
[CUSTOMER][NEUTRAL] I'm sorry, go ahead.
[AGENT][NEUTRAL] It was issued on [PII].
[AGENT][NEUTRAL] And it cleared on [PII].
[CUSTOMER][NEUTRAL] OK, there's a lot amount of patient responsibility.
[AGENT][NEUTRAL] Um, so we don't determine patient responsibility, but that is the allowed amount, the $75 was the allowed amount for the benefit.
[CUSTOMER][NEUTRAL] OK, so a loan amount was $75 and the provider got paid $75?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, is it possible I can receive a copy of the EOB?
[AGENT][NEUTRAL] Sure, what's a good fax number for you?
[CUSTOMER][NEUTRAL] Is my phone number [PII].
[AGENT][NEUTRAL] And do I put attention [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII]
[AGENT][NEUTRAL] All right, well, I will go ahead and fax this over to you now. And was there anything else I could assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Yes, can you spell your name for me and also give me a call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date, which is [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, so I'm gonna receive the copy of the EP today.
[AGENT][NEUTRAL] Oh, yes, I'm getting ready to send it to you now. I'm just noting the policy.
[CUSTOMER][POSITIVE] OK. Thank you. Have a good day.
[AGENT][NEUTRAL] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, ma'am. That'll be it.
[AGENT][POSITIVE] Alright, well, thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] OK, bye.
[AGENT][NEUTRAL] Bye bye.