AccountId: 011433970860
ContactId: 5b924edd-57f1-4213-9227-5321bb10872d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 357329 ms
Total Talk Time (AGENT): 141222 ms
Total Talk Time (CUSTOMER): 142139 ms
Interruptions: 4
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/5b924edd-57f1-4213-9227-5321bb10872d_20250519T12:42_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Good morning. Happy Monday. This is [PII] calling from provider's office, checking on our claims.
[AGENT][NEUTRAL] OK, [PII], you're needing to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Mm, yes, sure.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and [PII], how many claims do you have today?
[CUSTOMER][NEUTRAL] Just one.
[AGENT][NEUTRAL] OK, yes ma'am. I can help you. What is the policy number for the member?
[CUSTOMER][NEUTRAL] ID number I have 949198.
[AGENT][NEUTRAL] 949-198. Was that what you said?
[CUSTOMER][NEUTRAL] 198. Yes, correct.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And any information either that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][NEUTRAL] Let.
[AGENT][NEUTRAL] And what is the date of service and total bill amount?
[CUSTOMER][NEUTRAL] [PII] for $3430 even.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Mm, yeah, sure.
[CUSTOMER][NEUTRAL] We submitted this claim on the [PII]. We uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, we made the secondary claim with the UOP.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I do show this claim was received on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 359-9436.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $1,277.75.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That was paid on single check 2043713.
[CUSTOMER][NEUTRAL] Don't you open the.
[CUSTOMER][NEUTRAL] I'm sorry. Um, you said the paid amount is $1,227.75. And this was paid via check.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] No, 1000.
[AGENT][NEUTRAL] No, ma'am. $1,2077.
[AGENT][NEUTRAL] 0.75 cents.
[CUSTOMER][NEUTRAL] Mhm. What is the check number again?
[AGENT][NEUTRAL] The check number is 2043713.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Issued on
[AGENT][NEUTRAL] And the
[AGENT][NEUTRAL] 449.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The same date as the process date.
[CUSTOMER][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] May I know is that the check was cleared or not?
[AGENT][POSITIVE] I can check that for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEGATIVE] As of now, it has not.
[AGENT][NEUTRAL] But because it was processed on [PII].
[CUSTOMER][NEUTRAL] OK. Is there any patient
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Uh-huh. OK.
[CUSTOMER][POSITIVE] I'm so sorry. No, no. I'm so sorry.
[AGENT][NEUTRAL] And ma'am, we do not determine patient responsibility, that would be up to the provider.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And if you need a copy of this explanation of benefits, you may print that by going to our portal, [PII]. [PII].
[CUSTOMER][NEUTRAL] Thank you so much. And could you please just verify the pay address for me where the check has to be cashed?
[AGENT][POSITIVE] Yes ma'am, you would get, you can verify that for me.
[CUSTOMER][NEUTRAL] OK. So, I just have one question. Do you have the, um, I mean, the street address or the uh PO box address?
[AGENT][NEUTRAL] The claim had the street address.
[CUSTOMER][NEUTRAL] Street address. All right. That is [PII].
[AGENT][NEUTRAL] No, ma'am, that is not what is on the claim.
[CUSTOMER][NEUTRAL] Do you have [PII]?
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And may I know what would be the call reference number for today's call?
[AGENT][NEUTRAL] Yes, ma'am, you would use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] Mhm. OK, sure, thank you so much, [PII], for your assistance. Have a great day and bye-bye for now.
[AGENT][POSITIVE] Well, you're welcome. I hope you do too, even if that is all I can help you with, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] You too, bye.
[AGENT][NEUTRAL] Bye-bye.