AccountId: 011433970860
ContactId: 4b59fb12-8111-429d-a21d-8942c3c68663
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 334019 ms
Total Talk Time (AGENT): 125222 ms
Total Talk Time (CUSTOMER): 121010 ms
Interruptions: 3
Overall Sentiment: AGENT=0.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/4b59fb12-8111-429d-a21d-8942c3c68663_20250513T17:59_UTC.wav
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[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] For calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to checking on the claim status. Can you spell your name for me?
[AGENT][NEUTRAL] Yes, it's [PII] And Ms. [PII], can you please give me your callback number just in case the call is dropped.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then, uh, what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] The patient's name is [PII] and the
[CUSTOMER][NEUTRAL] Member ID is D as in Delta 437280887.
[AGENT][NEUTRAL] OK. And you spell the last name [PII]?
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK. And what is the date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK [PII], I'm gonna need to transfer you now on over to 90 Degree Benefits so that they can check that claim status for you. It's gonna be a brief hold while I transfer you.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And the phone number is [PII].
[CUSTOMER][NEUTRAL] Mhm I can tell.
[CUSTOMER][NEUTRAL] One moment. Let me take a note. [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, it's gonna be a quick hold while I transfer you on over.
[CUSTOMER][NEUTRAL] This is the number I called. OK, you can transfer.
[AGENT][NEUTRAL] Oh, OK, you did call that number already? Is that what you said?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, this is the number I called.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let me look and see if I can find the member in the system and see if I have any information at all that may help you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEGATIVE] I hate going for them.
[AGENT][NEUTRAL] OK, and the claim that you're calling about, is it a medical claim? Is it a dental claim?
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] Medical, and do you know what state [PII] lives in, or have his social?
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] I do have a member ID and the address. Let me take a look on those.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Address, one moment.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The patient lives in
[CUSTOMER][NEUTRAL] 01 moment.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me see if I have a member on my system from [PII].
[AGENT][NEUTRAL] I think I do.
[AGENT][NEUTRAL] OK, I think I have found him. um, can you give me the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII] with the bill amount of $94.71.
[AGENT][NEUTRAL] OK, and what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] It's Epiphany Dermatology, PA.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold, Miss [PII] and see if I can find that claim for you and I'll be right back.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And I do have. You are on hold.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, thank you for holding for me, Miss [PII]. So looking on data service of [PII], I do not find a claim on file for that amount that you've given me $94.71.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, do you need a claim number for this one? I do have a claim number.
[AGENT][NEUTRAL] OK, what is that, please?
[CUSTOMER][NEUTRAL] It's 202-502-210266.
[AGENT][NEUTRAL] OK, I will need to transfer you now on over to 90 Degree Benefits that's one of their claim numbers, so it's gonna be a brief hold while I transfer you on over, OK?
[AGENT][NEUTRAL] It's gonna be a quick hold.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you for calling 90s. If you would like