AccountId: 011433970860
ContactId: 58c0685a-b058-485f-bb25-3015a9a947be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 342589 ms
Total Talk Time (AGENT): 150535 ms
Total Talk Time (CUSTOMER): 62496 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/58c0685a-b058-485f-bb25-3015a9a947be_20250404T17:33_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, good afternoon too. My name is [PII]. Initial my last name is [PII] for November. I'm contacting you from a facility for claim status for patient.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] OK, thank you. And [PII], again, my
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, and uh thank you. And [PII] how many claims do you have to check status on?
[CUSTOMER][NEUTRAL] I just have one claim for one patient.
[AGENT][NEUTRAL] OK. Yes, sir. I can help you with that. And what is the patient's policy number?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] The number is uh.
[CUSTOMER][NEUTRAL] 02578873
[AGENT][NEUTRAL] Thank you. One moment while I access the member's information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Yes, the name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount for her place.
[CUSTOMER][NEUTRAL] Yes, the date of service is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For $2250 even.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, so this claim was received.
[AGENT][NEUTRAL] [PII] the received date was [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 358.
[AGENT][NEUTRAL] 493 6.
[AGENT][NEUTRAL] And there was a benefit paid in the amount of $250.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] That was paid on single check.
[AGENT][NEUTRAL] 203.
[AGENT][NEUTRAL] 696 5.
[AGENT][NEUTRAL] And the remarks on this claim, one moment.
[AGENT][NEUTRAL] And the remarks state on this claim the maximum amount payable for this occurrence has been met.
[AGENT][NEUTRAL] Per occurrence means treatment for the same or related condition unless separated by a period of 90 days. Treatment for the same or related conditions separated by 90 days or an unrelated condition will be considered a new per occurrence.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and what about the address to where the check was sent? Could you kindly verify whether it is the correct one?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] [PII] excuse me, [PII].
[CUSTOMER][POSITIVE] Yeah, that's the correct one.
[CUSTOMER][POSITIVE] Well, thank you so much for the information.
[CUSTOMER][NEUTRAL] And uh that is all I have and what will be the reference number?
[AGENT][NEUTRAL] OK, the call reference number will be my name. Again, my name is [PII] first initial of last name [PII], and if you need a copy of this explanation of benefits, [PII], you may print that by going to our portal at [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] All right. Thank you so much and thank you and uh that is all. Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, well if that is all I can help you with and thank you again for calling APO and I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You too, bye bye.
[AGENT][POSITIVE] Yes sir, thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.