AccountId: 011433970860
ContactId: 4a278643-efa7-4bc3-9352-3fd51549dd8c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 814359 ms
Total Talk Time (AGENT): 208057 ms
Total Talk Time (CUSTOMER): 144824 ms
Interruptions: 3
Overall Sentiment: AGENT=1.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/4a278643-efa7-4bc3-9352-3fd51549dd8c_20250513T19:08_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] initial and my last name is [PII]. Calling to check uh claim status. Can you please assist me with that?
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] OK, [PII], I'm sorry, what was the patient's policy number?
[CUSTOMER][NEUTRAL] It is 00994158.
[AGENT][NEUTRAL] Hey [PII], any information that I provide for you today is the verification of benefits.
[AGENT][NEUTRAL] That's not a guarantee of payment. What is the patient's name and?
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Yeah, yeah, the first name going to be [PII] but.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the date of service and total bill amount please [PII]?
[CUSTOMER][NEUTRAL] It is [PII] with the bill amount of $265 even.
[AGENT][NEUTRAL] 265. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and you said the data service is [PII], is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[CUSTOMER][POSITIVE] Yes, correct. Correct.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Can you please tell me your name?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, so I do not have a claim on file, Mark, for this member for this data service and build out.
[CUSTOMER][NEUTRAL] No, but for this claim, we have previously called, uh, I can give you the claim number.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, you're giving then you need to give me a different, mhm you can give me the claim number.
[CUSTOMER][NEUTRAL] It is uh
[CUSTOMER][NEUTRAL] 33549494.
[AGENT][NEUTRAL] OK, and the bill amount on the claim is not what you're giving me.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] You said that the bill amount is 265. That is not what this claim is for.
[CUSTOMER][NEUTRAL] OK. Vermont.
[CUSTOMER][NEGATIVE] No, no, it is uh $220 even.
[AGENT][NEUTRAL] So the billed amount is 220 or 265?
[CUSTOMER][NEUTRAL] 220.
[AGENT][NEUTRAL] OK, and since you have the claim number, how can I help you with that?
[CUSTOMER][NEUTRAL] OK. Uh, can you please tell me the mode of payment?
[AGENT][NEUTRAL] Check
[AGENT][NEUTRAL] Single check.
[CUSTOMER][NEUTRAL] And what is the, uh, check number?
[AGENT][NEUTRAL] The check number on here is going to be 2021978.
[CUSTOMER][NEUTRAL] That is the claim paid amount?
[AGENT][NEUTRAL] 50.
[CUSTOMER][NEUTRAL] And the allowed amount
[AGENT][NEUTRAL] 50
[AGENT][NEUTRAL] This is a supplemental policy.
[CUSTOMER][NEUTRAL] Can you please tell me the check.
[AGENT][NEUTRAL] And as of now, it shows this check is still out.
[CUSTOMER][NEUTRAL] OK. What is the checking?
[AGENT][POSITIVE] It shows it's still outstanding. What is the address?
[CUSTOMER][NEUTRAL] Uh, one moment you see.
[CUSTOMER][NEUTRAL] Yeah, that, that's going to be [PII].
[AGENT][NEUTRAL] I'm sorry, give me the zip code one more time, please.
[CUSTOMER][NEUTRAL] It's uh [PII], sorry, [PII].
[AGENT][NEUTRAL] That is
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so it is still outstanding. Can you please uh reissue the check payments?
[AGENT][NEUTRAL] I can send a request to have it verified that it is still outstanding and have it approved to get it authorized for reissue.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So you sent, uh, uh, so you sent what? Can you repeat that?
[AGENT][NEUTRAL] I will send it to our financial department. I will send a request to our financial division to verify that it is indeed outstanding and to get it approved to void and reissue.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you send a request to the financial department and the financial department will check and uh whether it is still outstanding the why and they issue the payment, right?
[AGENT][NEUTRAL] I will
[AGENT][NEUTRAL] Correct, and they will authorize it to be voided and reissued. That is correct. And if you need a copy of the explanation of benefits for this claim.
[AGENT][NEUTRAL] If you do not already have that, you can also print it by going to our portal, Mark at [PII]. So give me just a moment to so that I can make that request. I'll need for you to remain on the line while I do that.
[CUSTOMER][POSITIVE] OK. Take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] Mm, it takes a few moments, [PII], for me to make this request. So thank you for your patience.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I have submitted that request, Mark, to have this verified as being still outstanding and approve it to be voided and reissued. And once that has been done, provided it is able to be reissued, it will, I would allow approximately 5 to 7 business days.
[AGENT][NEUTRAL] If you want to follow up on that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once it has been reissued, once it has been reissued, it will take up to 10 business days for that to be received, typically in the mail.
[CUSTOMER][NEUTRAL] For the record, did you have any tickets, sir?
[CUSTOMER][NEUTRAL] OK. And what, OK.
[CUSTOMER][NEUTRAL] OK. What is the ticket number for the request?
[AGENT][NEUTRAL] Um, you would use, um, the reference num[PII] for our call is my name in today's date.
[CUSTOMER][NEUTRAL] So that will be the ticket number for the request you send to the financial department.
[AGENT][NEUTRAL] Uh, that our internal system will be able to see when you call back to follow up that this ticket was submitted, but that's not information that I can provide for you. That's an internal number.
[CUSTOMER][NEUTRAL] OK, at this uh call reference number.
[AGENT][NEUTRAL] My name and today's date.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, [PII]. Can you please tell me the, OK, [PII], thank you for the knowledge. Have a great day, bye.
[AGENT][POSITIVE] OK. Oh well, you're very welcome. And is there anything else, [PII] I can help you with today?
[CUSTOMER][POSITIVE] That's all for today. Thank you for the assistance. Have a great day. Bye.
[AGENT][POSITIVE] OK, well thank you again for calling APL and I hope you have a nice afternoon.
[AGENT][POSITIVE] Or a nice rest of your day.
[CUSTOMER][POSITIVE] Yeah, have the rest of your day. Bye.
[AGENT][NEUTRAL] All right, bye bye.