AccountId: 011433970860
ContactId: 5e03cbea-9b67-406a-ad83-8972126f6151
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 457429 ms
Total Talk Time (AGENT): 209765 ms
Total Talk Time (CUSTOMER): 139887 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/5e03cbea-9b67-406a-ad83-8972126f6151_20250522T16:30_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I'm calling from Lexington Health Incorporated for Lexington Orthopedics.
[CUSTOMER][NEGATIVE] And I had called a few days ago and put in a request for an EOB to be sent, uh, faxed over to me and I have not received it as of yet.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so you're just needing an explanation of benefits for a claim, [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And [PII], what is a good call back number for you please?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][POSITIVE] Oh, I'm, I'm so sorry.
[CUSTOMER][POSITIVE] That's OK. No, no, no, it's quite all right. It's close.
[AGENT][NEUTRAL] OK. Well, I guess I'm so used to people spelling [PII] wrong that I, now I can't hear when somebody gives me their name. But I'm sorry, um, what's the member's policy? What's your callback number, [PII]?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] [PII]. Now how do you spell your name?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I think I did talk to you the other day.
[AGENT][NEUTRAL] You may have, you may have. I'm the only [PII], but what is the member's policy number, [PII]?
[CUSTOMER][NEUTRAL] Member's policy number is.
[CUSTOMER][NEUTRAL] 02569870
[AGENT][NEUTRAL] OK, thank you one moment while I get that pulled up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so any information that I do provide for you will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. So it wasn't me that you spoke to the other day. Is the fax number [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am it is.
[AGENT][NEUTRAL] Yes, ma'am, it was sent.
[AGENT][NEUTRAL] Did um, did you
[CUSTOMER][NEUTRAL] Wonder why didn't we, you know, it's, it's a general fact that sometimes, um, well we all share the facts, so it, it's possible that someone picked it up and just didn't put it on my desk. Would it be too much for for it to be refaxed to me, please?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment to get um some other information pulled up.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And the claim number was 3593156. Is that correct?
[CUSTOMER][NEUTRAL] Yes, yes, ma'am.
[CUSTOMER][NEUTRAL] And what is the first initial of your last name, [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And when you spoke to the other representative of the other day, did they give you by chance the portal website where you can also try and print it yourself, [PII]?
[CUSTOMER][NEUTRAL] Um, is that the IMA? Let me make sure.
[AGENT][NEUTRAL] No, no, this one would have been secured. [PII].
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] Perfect, I'm gonna go ahead and fax this to you again, but just so that you have that for future reference, you should be able to
[CUSTOMER][NEUTRAL] Let me just make sure.
[AGENT][NEUTRAL] Locate especially now with the claim number.
[CUSTOMER][NEUTRAL] Yes, I did a [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] It's secured in front of it.
[AGENT][NEUTRAL] The first word
[AGENT][NEUTRAL] Uh-huh, [PII]. [PII]. That's the portal website.
[CUSTOMER][NEUTRAL] Cause I was, I was able to register without.
[AGENT][NEUTRAL] They're in the process of making a few changes on our portal, so it's possible that there was a different route that you went to, but if you were able to register as a new user under a provider.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is that what you did? Sounds like you went to the right place, so you should be able, you should be able to use that claim number to access that EOB.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEGATIVE] But I'm still waiting for mine to load.
[CUSTOMER][NEUTRAL] And I think you know what, let me.
[AGENT][NEUTRAL] I'm still waiting for mine to load up the fax to you.
[CUSTOMER][NEUTRAL] Provider resources.
[CUSTOMER][NEUTRAL] Now would I search on the claim status of claims and forms.
[AGENT][NEUTRAL] Claim status.
[AGENT][NEUTRAL] And this type of policy, sometimes they are not always accessible just because of how these claims are processed.
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] Uh huh
[AGENT][NEUTRAL] If you're signed in you can certainly try and again that fax number I just wanna re-verify it's [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I have just sent that to you again.
[AGENT][NEUTRAL] And I did put attention [PII].
[CUSTOMER][NEUTRAL] OK, thank you, thank you. OK, so let me see.
[AGENT][POSITIVE] Oh, you're very welcome. Yes, ma'am.
[CUSTOMER][NEUTRAL] I was trying to see if I could get one here or not.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And the um
[CUSTOMER][NEUTRAL] The reference call for today is [PII] I.
[CUSTOMER][NEUTRAL] And your last initial and today's date?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh-huh. My name is [PII], first initial the last name is [PII], and my name in today's date would be your call reference number.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] So provided there's not any issues, it should be coming to you and again I did put attention [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Alrighty then I thank you so much, [PII].
[AGENT][POSITIVE] Uh, well, you're very welcome. Is there anything else that I could help you with today?
[CUSTOMER][POSITIVE] No ma'am, that will be all you have a great weekend.
[AGENT][POSITIVE] Oh well thank you so much. I hope you do too, and thank you again for calling APL [PII]. It was my pleasure in talking to you today.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK you too now bye bye.
[AGENT][POSITIVE] Thank you. Uh-huh. Bye-bye.