AccountId: 011433970860
ContactId: 52bf0bc8-b82b-4926-a4bd-77d0b1f61942
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 527159 ms
Total Talk Time (AGENT): 175917 ms
Total Talk Time (CUSTOMER): 125542 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/52bf0bc8-b82b-4926-a4bd-77d0b1f61942_20250214T14:05_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, very good morning. I'm [PII] calling from provider's office to discuss about the claim. And I have to inform you this call is recorded for quality and training purpose. Is it OK?
[AGENT][NEUTRAL] That is fine. Could you spell your name for me, please?
[CUSTOMER][NEUTRAL] Uh sure. My first name is [PII] and it's spelled as [PII] and initial to my last name is [PII].
[AGENT][NEUTRAL] OK, [PII], and you're needing additional information on a claim that you already have a claim number on or are you needing to check claim status?
[CUSTOMER][NEUTRAL] Uh, actually, I need, I'm checking claim status.
[AGENT][POSITIVE] Yes, I can help you with that. And see, what is a callback number for you please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And how many claims do you have to check status on for?
[CUSTOMER][NEUTRAL] Yeah, actually, I have only one claim.
[AGENT][NEUTRAL] OK. And what is that member's policy number?
[CUSTOMER][NEUTRAL] 023 04847 M like Mary, L like Lima.
[CUSTOMER][NEUTRAL] And the number 8.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] And to heal any information that is provided today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you and what is the date of service and total bill amount for her place?
[CUSTOMER][NEUTRAL] Uh, it is for [PII]. Charge amount is $229 even.
[AGENT][NEUTRAL] 229. Is that correct?
[CUSTOMER][NEUTRAL] 229, yes.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, and again, you said the data service is 66 of 2024?
[CUSTOMER][NEUTRAL] Uh 67 of 2024.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, so this claim was processed received rather on [PII].
[AGENT][NEUTRAL] Processed on [PII].
[AGENT][NEUTRAL] The claim number is 3549416.
[AGENT][NEUTRAL] There was a benefit paid on this in the amount of $61.30.
[AGENT][NEUTRAL] That was paid on single check 202.
[AGENT][NEUTRAL] 1851.
[AGENT][NEUTRAL] I was a
[AGENT][NEUTRAL] As of now, that check does still show as open.
[CUSTOMER][NEUTRAL] And uh on which date the check was issued?
[AGENT][NEUTRAL] One, the same date as the process date, [PII].
[CUSTOMER][POSITIVE] OK, perfect. And did you guys submit it, mhm, yes.
[AGENT][NEUTRAL] I can
[AGENT][NEUTRAL] Yes, please verify the address for the claim.
[AGENT][NEUTRAL] For the provider?
[CUSTOMER][NEUTRAL] Uh yes. Yeah, the provider's mailing address is [PII].
[AGENT][NEUTRAL] Give me the [PII] number again.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and that is where this check has been mailed to.
[CUSTOMER][NEUTRAL] And UB was also mailed to the
[CUSTOMER][NEUTRAL] Address
[AGENT][NEUTRAL] That is correct. And you may also print the EOB if you need a copy of that. You can go to our portal, Sahel at [PII], and now that you have the claim number, you should be able to print that explanation of benefits.
[CUSTOMER][NEUTRAL] OK. And is there any logins or credentials to uh log into the portal?
[AGENT][NEUTRAL] It is a self register, yes sir, it's just it's a self registering portal and you would set up your own username and password and just answer the questions.
[AGENT][NEUTRAL] that it asked regarding the provider's information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Perfect. And can you send the, uh you will be via fax or uh we have to get it via portal?
[AGENT][NEUTRAL] I'm sorry, what was your question again?
[CUSTOMER][NEUTRAL] Uh, actually, uh, we are not, uh, logged into portal, so can you please send it via fax?
[AGENT][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's still loading.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And will it need to be put to your attention, [PII]?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK. So one moment. Still waiting.
[AGENT][NEUTRAL] I apologize about the delay. It's just taking a moment to load the information.
[CUSTOMER][POSITIVE] Uh, yeah, no problem.
[AGENT][NEUTRAL] And what is your fax number please, [PII]?
[CUSTOMER][NEUTRAL] Uh, yeah, fax number will be [PII].
[AGENT][NEUTRAL] OK, again, that's [PII]. Is that correct?
[CUSTOMER][POSITIVE] Yes. Yes, perfect.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And can I have the spelling of your name and contactence number?
[AGENT][NEUTRAL] OK just one moment.
[AGENT][NEUTRAL] OK, again, my name is [PII] first initial to my last name is [PII], and my name and today's date so here will be your call reference number.
[CUSTOMER][POSITIVE] OK, that's perfect. Thank you so much once again and you have a great day ahead.
[AGENT][POSITIVE] You're very welcome. I hope you have a great day too, and if that's all I can help you with then thank you again for calling APL.
[CUSTOMER][NEUTRAL] Yes, bye-bye.
[AGENT][NEUTRAL] No, bye-bye.