AccountId: 011433970860
ContactId: 461341c6-5cea-4de5-aa0b-de5add313a58
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 487760 ms
Total Talk Time (AGENT): 158554 ms
Total Talk Time (CUSTOMER): 125534 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/461341c6-5cea-4de5-aa0b-de5add313a58_20250408T18:35_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from provider office checking for claims.
[AGENT][NEUTRAL] Hi.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status. [PII]. May I have a good contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] Yes, contact number. Yes, contact number is [PII]. It's a direct line, no extension.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the policy number whenever you're ready.
[CUSTOMER][NEUTRAL] Yes, I'm ready for the policy number, that is 02338486. Again, 02338486.
[AGENT][NEUTRAL] OK, hold on one moment. Thank you for that.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure, sure.
[CUSTOMER][NEUTRAL] First name is [PII]. Date of birth, [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 bills for the claim?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes, I do have a data service.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, dated service, [PII] this year. The total bill amount $762.06.
[AGENT][NEUTRAL] 762.06.
[CUSTOMER][NEUTRAL] Yes, correct. 762.06.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And may I have your name, please?
[AGENT][NEUTRAL] Sure, my name is [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, sure. Thank you.
[AGENT][NEUTRAL] You're welcome. And [PII], do you mind if I place you on just a brief hold while I locate the claim?
[CUSTOMER][POSITIVE] Sure, sure. Take your time.
[AGENT][NEUTRAL] You're welcome. Hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] So why was it 150?
[AGENT][NEUTRAL] What was the benefit?
[AGENT][NEUTRAL] 0000, it was 75 for the wellness and then 75 for the
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes, I'm here, [PII].
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. So, we received the claim on [PII].
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] That claim number is 358.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 4325.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], we paid out on the claim a total of $150.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Did you need the check information?
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Yes, I need to check the information. You paid for the code, uh, how much you paid for the code 99203?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] $75.
[CUSTOMER][NEUTRAL] So totally, you paid $150 for the code $75 correct?
[AGENT][NEUTRAL] Right, for both codes, $75.
[CUSTOMER][NEUTRAL] OK, OK. Sure. May I get the check number?
[AGENT][NEUTRAL] Sure, it's 203.
[AGENT][NEUTRAL] 7309.
[CUSTOMER][NEUTRAL] It was a simple check or by check?
[AGENT][NEUTRAL] It was a single check.
[AGENT][NEUTRAL] Um, in the amount of 150, and I'm sorry?
[CUSTOMER][NEUTRAL] Uh-huh. Is she good?
[CUSTOMER][NEUTRAL] Issue date, check issued.
[AGENT][NEUTRAL] It was issued on [PII].
[CUSTOMER][NEUTRAL] And can I get the check cash, please?
[AGENT][NEUTRAL] It hasn't been cleared yet. Um, it was just sent out, but it was mailed to [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, so it's coming from [PII].
[CUSTOMER][NEUTRAL] And uh can you please request
[CUSTOMER][NEUTRAL] Sure, sure. May I, can you please request a copy of UB to the fax number?
[AGENT][NEUTRAL] Sure, what's a good fax number for you?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So the code 99203, not denied. It was paid, correct?
[AGENT][NEGATIVE] Right, neither of the codes were denied. It was paid $70 each code was paid $75 which is the max for each of the benefits used.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, sure.
[AGENT][NEUTRAL] And your fax number whenever you're ready.
[CUSTOMER][NEUTRAL] [PII]. Attention is my name, [PII].
[AGENT][NEUTRAL] OK, and that's [PII]. Attention, [PII].
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] All right, well, I'm sending this to you now. Um, so we usually say to give the faxes uh at least an hour. If you haven't received it by end of day today, um, you can definitely give us a call and we'll be more than happy to resend it for you.
[CUSTOMER][NEUTRAL] Sure, sure. Thank you. And uh what is the call reference number for you?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Thank you. Thank you so much. Bye bye.
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, nothing. Thank you. Thank you so much.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thank you. Bye.
[AGENT][NEUTRAL] Bye bye.