AccountId: 011433970860
ContactId: 4ad89076-b391-4510-9aed-f3af82f8d215
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326299 ms
Total Talk Time (AGENT): 127934 ms
Total Talk Time (CUSTOMER): 65627 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/4ad89076-b391-4510-9aed-f3af82f8d215_20250617T14:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh yes, I was calling regarding a claim.
[AGENT][NEUTRAL] OK, you are you needing claim status?
[CUSTOMER][NEGATIVE] I'm, I'm needing actually to get the explanation of benefits. It was supposed to have been sent over already, but we haven't, we never, we never did receive it.
[AGENT][NEUTRAL] OK, so you're trying to get an explanation of benefits, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can try and help you with this, and who am I speaking with please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm so sorry. There was a ding on my end for a message that, uh, could you please repeat your number because it totally cut part of it out.
[CUSTOMER][NEUTRAL] Yeah, it's [PII]
[CUSTOMER][NEUTRAL] That's OK, [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 01885798
[AGENT][POSITIVE] Alright thank you give me a moment to get the member's information pulled up.
[AGENT][NEUTRAL] Alright, and any information provided would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII], um, [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the date of service and total bill amount, [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] March
[CUSTOMER][NEUTRAL] And it's [PII], uh 124.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what was the date of service one more time? I'm sorry, I think I misheard you.
[CUSTOMER][NEUTRAL] That's OK, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said it was $124 is the total bill amount?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Now,
[AGENT][NEUTRAL] I don't have a claim for her for that data service for that build amount. 321 of 2025.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] For $124.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am, we don't have an EOB for that. I mean, we don't have a claim for that bill amount.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, alright, I can resend it, um, and can I ask you another question? Can you tell me what the fee schedule is for this insurance?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] This, uh, is based on the use of the covered services are based on a percentage of the UCR of the service region.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So there's, that's how the.
[AGENT][NEUTRAL] That's how everything is based on this policy.
[CUSTOMER][POSITIVE] OK, OK, alright, thank you.
[AGENT][NEUTRAL] You're welcome. And now, um just one more thing, [PII], I do wanna give you, so you're gonna resend you're gonna submit the claim, correct?
[CUSTOMER][NEUTRAL] Right, mhm.
[AGENT][NEUTRAL] OK, now once we have received the claim and processed it, we do have a portal that you should be able to check claim status in.
[AGENT][NEUTRAL] And the website for our Portal [PII] is located at secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, got it. Alright, thank you so much.
[AGENT][POSITIVE] OK. Well, you are certainly very welcome. And is there anything else that I could help you with today?
[CUSTOMER][POSITIVE] That's all thank you.
[AGENT][POSITIVE] OK, well, you're welcome and thank you again for calling APL and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.