AccountId: 011433970860
ContactId: 5d7c84fa-c7eb-4e52-a09e-7c5542e943eb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 657750 ms
Total Talk Time (AGENT): 140321 ms
Total Talk Time (CUSTOMER): 189702 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/5d7c84fa-c7eb-4e52-a09e-7c5542e943eb_20250425T18:02_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, hello. Hi, yeah, good afternoon. Good afternoon. My name is [PII]. I call from the Center for Bone and Joint Surgery of the Palm Beach. I have a question for the claim status.
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] You need to check on a claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] Um 01.
[CUSTOMER][NEUTRAL] A A
[CUSTOMER][NEUTRAL] 546 2
[CUSTOMER][NEUTRAL] M
[CUSTOMER][NEUTRAL] Uh, LA.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Member's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] Leader [PII].
[AGENT][NEUTRAL] And the build out.
[CUSTOMER][NEUTRAL] And the bill amount is
[CUSTOMER][NEUTRAL] 100
[CUSTOMER][NEUTRAL] 157.78 cents.
[AGENT][NEUTRAL] Do you have an amount after the primary paid?
[CUSTOMER][NEUTRAL] Uh, because this year.
[AGENT][NEUTRAL] Did you have an amount after the primary pay that was different?
[CUSTOMER][NEUTRAL] Oh, let me see. Um.
[CUSTOMER][NEUTRAL] No, I don't see.
[CUSTOMER][NEUTRAL] I have only in
[CUSTOMER][NEUTRAL] Once again
[CUSTOMER][NEUTRAL] In [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] We call
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So I speak to [PII] as per he never received claims so send, I send the mail.
[CUSTOMER][NEUTRAL] So I, I, I don't know if you receive.
[AGENT][NEUTRAL] What was the mailing address it was sent to?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][POSITIVE] Good
[CUSTOMER][NEUTRAL] See
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Can you confirm that bill amount again? It was 1100.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 127.
[CUSTOMER][NEUTRAL] 157.78 cents.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 4
[AGENT][NEUTRAL] Right, so it looks like we did receive a claim for the state of service uh back on [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII], sorry?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] I have [PII].
[CUSTOMER][NEUTRAL] So do, do you not have.
[CUSTOMER][NEUTRAL] Decline
[AGENT][NEUTRAL] Yes, there was a claim, there was a claim received on [PII].
[CUSTOMER][NEUTRAL] Do you know receipt? Oh.
[CUSTOMER][NEUTRAL] Oh, Feb, A.
[CUSTOMER][NEUTRAL] [PII], correct?
[AGENT][NEUTRAL] No, [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Of [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I, I don't understand because the claim.
[CUSTOMER][NEUTRAL] Is the the service [PII].
[AGENT][NEUTRAL] That was a duplicate claim to that.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] Porque come over and get a claim better.
[AGENT][NEUTRAL] That was the date that the original it's showing was received. We received a secondary claim on [PII]. That was processed on [PII], showing it as a duplicate claim.
[AGENT][NEUTRAL] The original claim, which was processed and paid, let me see, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It showed that the payment was sent out on [PII].
[CUSTOMER][NEUTRAL] Oh this payment?
[AGENT][NEUTRAL] I'm sorry, what was your question again?
[CUSTOMER][NEUTRAL] Yeah, um
[CUSTOMER][NEUTRAL] Thispla his payment or what is the reason for denial?
[AGENT][NEUTRAL] The claim was paid on [PII]. There was a single check sent in the amount of $67.24.
[CUSTOMER][NEUTRAL] I'm sorry, can you repeat, uh, sorry, um, [PII], is paying, correct?
[AGENT][NEUTRAL] 08.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] A.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, do you hear me?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, sorry, it's
[CUSTOMER][NEUTRAL] Uh, [PII] or April?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, [PII], correct?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] OK, again, the date of that it was paid is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Of [PII].
[CUSTOMER][NEUTRAL] OK. Uh, how much is the payment?
[AGENT][NEUTRAL] $67.24.
[CUSTOMER][NEUTRAL] Uh, do you have the checking number?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. $67.24. OK, got it. Perfect.
[AGENT][NEUTRAL] Did you need me to check anything else?
[CUSTOMER][POSITIVE] Oh, that's it. Thank you for your help. I'm sorry, can you repeat your name one more time?
[AGENT][NEUTRAL] My name is [PII], that is spelled [PII].
[CUSTOMER][NEUTRAL] And your reference number?
[AGENT][NEUTRAL] Is my name. What's today's date?
[CUSTOMER][POSITIVE] OK, perfect. Thank you, [PII]. Thank you for your help and happy weekend.
[AGENT][NEUTRAL] You too. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.