AccountId: 011433970860
ContactId: 5088b331-29ea-4898-8290-35e3e1ebc509
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 393179 ms
Total Talk Time (AGENT): 135853 ms
Total Talk Time (CUSTOMER): 189746 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/5088b331-29ea-4898-8290-35e3e1ebc509_20250506T17:07_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] Hello, [PII]. My name is [PII]. Last name to my initial is [PII]. I'm calling from the provider's office, Mercy Clinic, to check on a claim status. Could you please help me with that?
[AGENT][POSITIVE] Yes, I'll be more than happy to help you with the claim status on me. May I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh yeah. Mhm yeah, sure. The callback number, it's a direct line, [PII]. And the member's ID number, it's gonna be 02462882.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm yeah sure.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yup, sure. The member's uh last name is [PII] and the date of birth on [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?
[CUSTOMER][NEUTRAL] 611-604.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yup, sure. It's on [PII] with the total charge amount, $287 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah, sure. Actually, we did uh refiled this claim more than 2 times. I think we refiled this um around 4 times. The last we refiled this claim on [PII] through mailing.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so we've only APL has only received the claim once. Did you, did you process it with the primary more than once because we only have one claim here.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For this data service.
[CUSTOMER][NEUTRAL] OK, no problem. But we, OK, but we, we filed the claim because we didn't get a response from APL, so that's it, but that doesn't matter. Anyway, you have received the claim. So may I have just to know the status of the claim?
[AGENT][NEUTRAL] Yes, hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] 253.
[AGENT][NEUTRAL] Alright, so I'm showing received the claim on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 3531921.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on [PII], we paid out on the claim $56.60.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect. And may I know is it an EFT payment or a check payment?
[AGENT][NEUTRAL] So it's a single check, um, check number 2014647.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] It was issued on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was mailed to [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Or is that [PII], I'm sorry.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, in [PII], is that the correct address?
[CUSTOMER][NEUTRAL] [PII]. Oh yeah, sure. And, and the ZIP code is [PII]?
[AGENT][NEUTRAL] Yes, but I am still showing that the check is outstanding, so I can send the request to have the check checked on, and if we need to void and reissue this to you all we can.
[CUSTOMER][NEUTRAL] What it's called
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK. So, the check is showing outstanding there.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, let me check here. Uh, may, may I know like, uh, outstanding means? Oh, when did that, when did that happen? Yeah.
[AGENT][MIXED] Outstanding, it has not cleared.
[CUSTOMER][NEUTRAL] Not clear it. OK, so if there is any turnaround time, specific turnaround time for this one?
[AGENT][NEUTRAL] So what I'm doing is sending a request so that we can check on the check and get it reissued if it needs to be. Um, so we usually say around 10, 7 to 10 business days from um when I sent so from today.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh huh, yeah, perfect. Thank you. Thank you so much for that and let me check that is it a sing OK, you said you already said that it was a single payment. OK, perfect. Thank you. And also can you please fax me this paid EOBN.
[AGENT][NEUTRAL] Sure, and what's a good fax number for you?
[CUSTOMER][NEUTRAL] Yeah, sure. Uh, it's gonna be [PII]. And, and please add my attention to my name, which is [PII]. Last name to my initial is [PII].
[AGENT][NEUTRAL] Alright, that was [PII]. I mean, [PII].
[CUSTOMER][POSITIVE] Yeah, absolutely, yeah, mhm perfect.
[AGENT][POSITIVE] All right, well, I'll go ahead and send this over to you now. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Oh, all good, thank you, thank you so much for asking and uh last may I have the call reference number in?
[AGENT][NEUTRAL] Sure, 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][NEUTRAL] OK. Is it [PII] or [PII]?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][POSITIVE] OK, [PII]. OK, perfect. I thought it's [PII]. OK, perfect. Thank you. Thank you so much, [PII], for assisting me today and have a great day.
[AGENT][POSITIVE] You also, and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah bye bye.