AccountId: 011433970860
ContactId: 5bc162f0-920b-4325-8d92-a3ab2158eb8d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 299179 ms
Total Talk Time (AGENT): 152780 ms
Total Talk Time (CUSTOMER): 127770 ms
Interruptions: 5
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/5bc162f0-920b-4325-8d92-a3ab2158eb8d_20250206T20:35_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Uh hi [PII], this is [PII] calling from a provider's office, and I have a question to see if a claim has been received, please.
[AGENT][POSITIVE] Yes, ma'am. [PII], I'll be glad to help you go ahead and give me a good policy number.
[CUSTOMER][NEUTRAL] Yes, ma'am. 350641.
[AGENT][NEUTRAL] That's 350641.
[CUSTOMER][POSITIVE] That is correct.
[AGENT][POSITIVE] Alrighty.
[CUSTOMER][NEGATIVE] Oh, you know what, that's not the right policy number. Oh.
[AGENT][NEGATIVE] And don't sound right, [PII], but
[CUSTOMER][NEUTRAL] No, as I'm looking, that's what's on the claim, but as I'm looking at the card and maybe that's why you don't have it. So let's try this number it's 650-641.
[AGENT][NEUTRAL] That sounds like more it. All right, [PII], while I'm pulling this up for you, go ahead and give me a good return telephone call number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Alrighty, let's see.
[AGENT][NEUTRAL] What's your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Uh, it looks like Raymond is the insured on this plan. That is the correct policy number. Uh, you said you just wanted to check status of a claim. Is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right, yes, I'm wondering if you've received a claim, yeah.
[AGENT][NEUTRAL] Oh, let me.
[AGENT][NEUTRAL] What's the date of service, [PII]?
[CUSTOMER][NEUTRAL] [PII] $468.
[AGENT][NEUTRAL] And what was that data server? I'm sorry.
[CUSTOMER][NEUTRAL] You're fine. [PII].
[AGENT][NEUTRAL] OK, [PII], and it's for 468?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Alright, give me just a moment. Let me see.
[CUSTOMER][NEUTRAL] You're fine.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Where's your bill gonna be from [PII]?
[CUSTOMER][NEUTRAL] Uh, it is from Mercy Clinic, Fredericktown.
[AGENT][NEUTRAL] 468.
[CUSTOMER][NEUTRAL] Our Mercy Clinic East.
[AGENT][NEUTRAL] Hm.
[AGENT][POSITIVE] Alright, let's see if this is it. I'm gonna try to help you. You actually have the dental department, but I, I'm gonna try to help answer your question. Let's see.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] How did that happen?
[AGENT][NEUTRAL] OK, and your bill is for 48. Yeah, I do see it.
[CUSTOMER][NEUTRAL] Well, I called the number on the back of the card.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's OK. Um, yeah, I do say that the claim is here. It looks like there's a payment of $21 that is going to the insured though. She got, they got a $21 check.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Like 21 even.
[AGENT][NEUTRAL] Yes, ma'am. 21 even.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Um,
[AGENT][POSITIVE] Yeah, but that is it. I'd be glad to give you the claim number as well.
[CUSTOMER][NEUTRAL] Is.
[CUSTOMER][NEUTRAL] Yes, I will. And is there any way we could get a copy of that remit sent to us for our records?
[AGENT][NEUTRAL] Did you send this bill in as signed [PII]?
[CUSTOMER][NEUTRAL] Um, let's see here.
[CUSTOMER][NEUTRAL] Yes, we did.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][POSITIVE] Paper claim and accept assignment, yes, we sure did.
[AGENT][NEUTRAL] I pay that. OK, go ahead and give me a good fax number, OK?
[CUSTOMER][NEUTRAL] Yes, 573.
[CUSTOMER][NEUTRAL] 519-532-7
[AGENT][NEUTRAL] Alright, [PII], and I'm gonna.
[AGENT][NEUTRAL] Get that ELB faxed over to you, OK?
[CUSTOMER][NEUTRAL] OK and um can we go ahead and can you give me that claim number if you don't mind please?
[AGENT][NEUTRAL] Yeah, it is 353-249-4.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And was there any patient responsibility after that? $21.
[AGENT][NEUTRAL] Oh, that I can't answer. Hm, I can just tell you what we pay, yeah, but I will get that AOB face cover. OK, alright, [PII], was that all I can help you with?
[CUSTOMER][NEUTRAL] OK, that's OK well I'll wait for.
[CUSTOMER][NEUTRAL] OK, well I'll wait for the EOB.
[CUSTOMER][NEUTRAL] OK. May I have a
[CUSTOMER][NEUTRAL] Just a reference number for the call, please.
[AGENT][NEUTRAL] Well, we don't give reference numbers, [PII], but you can use my name with today's date and my name is [PII], OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thanks, [PII]. I appreciate it.
[AGENT][POSITIVE] Yes, ma'am, yes ma'am. And thanks for calling APO [PII]. You have a great rest of your day. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Have a good day.
[CUSTOMER][POSITIVE] You as well. Thank you, ma'am. Bye bye.
[AGENT][NEUTRAL] Mhm. Bye-bye.