AccountId: 011433970860
ContactId: 56ae9df7-9942-4b11-8432-02bb726804ba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362549 ms
Total Talk Time (AGENT): 127579 ms
Total Talk Time (CUSTOMER): 134023 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/56ae9df7-9942-4b11-8432-02bb726804ba_20250224T20:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling you from provider's office, checking on name status.
[AGENT][NEUTRAL] OK, I could check on a claim for you. [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. [PII]. It's the direct line.
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 02555046.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Uh, what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The patient's first name is [PII], and the last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that, [PII]. Uh, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yeah, date of services [PII] total charge $288 even and I have a specific concern regarding this claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, all right, one moment, let me find that.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Do you happen to have that claim number, [PII]?
[CUSTOMER][NEUTRAL] Yeah, the claim number is
[CUSTOMER][NEUTRAL] 356-053-3
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] And this was for [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, yes, it looks like we paid a benefit of $53.89. Um, what questions did you have regarding this claim?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, yeah, as per checking, previously, our colleague has worked on this claim. As the representative has stated that it was paid to incorrect address and uh representative has suggested to submit a W9 form. We have submitted the W9 through fax, which is 8773659423 on [PII]. Can you please check on it?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm not showing that it has been received yet, [PII], um, but it's possible that it's just, uh, still being processed. It can take several business days, um, and if it was submitted on the [PII].
[AGENT][NEUTRAL] I would call back, um, yeah, I would call back maybe on a Thursday or Friday and that should have been updated.
[CUSTOMER][NEUTRAL] Processed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and just to confirm the fax number which I gave you if it's the correct time, right?
[AGENT][NEUTRAL] Yeah, that is our fax number.
[CUSTOMER][NEUTRAL] OK. And can you please verify me the, to which address the check was issued on?
[AGENT][NEUTRAL] Yeah, I can take a look at that. Give me just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so this check was sent to [PII].
[CUSTOMER][NEUTRAL] OK, sure. Uh, yeah, that's the same address uh our colleague has documented. OK. So it will allow more time for this one. Thank you. And uh can we check for the next number?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] We have another time we need to check?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and this was for a different policy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Give me just a moment.
[AGENT][NEUTRAL] OK, you could go ahead and give me that policy number.
[CUSTOMER][NEUTRAL] Yeah. 02415249.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for this number?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for that and then what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Uh, date of service is [PII]. Total charge $459 even.
[AGENT][NEUTRAL] OK, that was [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII], we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK. Can I get the claim received date and denied date?
[AGENT][NEUTRAL] Yes, give me just a moment, let me find that.
[AGENT][NEUTRAL] So the claim was received [PII].
[AGENT][NEUTRAL] And it was processed [PII].
[CUSTOMER][NEUTRAL] OK. And can I get the claim number, please?
[AGENT][NEUTRAL] Mhm, it is 353-976-8.
[CUSTOMER][NEUTRAL] 768 just to confirm 353-9768. I'm right?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK. And may I have your name spelled, please?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][POSITIVE] OK. uh OK. It was great speaking with you. Have a good day. Bye-bye.
[AGENT][NEUTRAL] Was there anything else I can help you with, sir?
[CUSTOMER][POSITIVE] Uh, no, no, it was, it was great speaking with you. Have a good day. Bye-bye.
[AGENT][POSITIVE] OK, alright, thanks for calling APO you too bye bye.