AccountId: 011433970860
ContactId: 64ec9a22-ddcd-42db-9482-2d740f8a593f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 665799 ms
Total Talk Time (AGENT): 254896 ms
Total Talk Time (CUSTOMER): 166492 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/64ec9a22-ddcd-42db-9482-2d740f8a593f_20250123T18:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] calling from provider's office looking for claims status.
[AGENT][NEUTRAL] OK, yeah, I could check on a claim for you. I'm sorry, uh, you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Oh [PII], OK, uh, and can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] Uh yeah. 10638489. M as in Mary, L as in Lima, number 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Let's see, I'm sorry, [PII], could you repeat that policy number? I don't think I heard it correctly.
[CUSTOMER][NEUTRAL] Sure. 10638489 M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, yeah, I'm not getting anything with that number, [PII]. I don't think that's one of ours um do you maybe have their social I could search for them that way?
[CUSTOMER][NEUTRAL] Uh yeah, sure. Just a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh yeah. So the social security number is?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] And what was the name of the patient?
[CUSTOMER][NEUTRAL] Yeah. [PII], [PII].
[AGENT][POSITIVE] OK, perfect. I did find that policy. Give me just a moment.
[AGENT][NEUTRAL] OK, so, um, the policy number you gave me, it's 01 not 10.
[AGENT][NEUTRAL] At the beginning of the policy, so it's 01638489.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] OK. Uh, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yeah, [PII] with the bill amount $974.06.
[AGENT][NEUTRAL] OK, that was [PII]?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] I'm sorry [PII], what was the name of the uh provider, the provider's office?
[CUSTOMER][NEUTRAL] Yeah, the, yeah, the facility name is Miami Hematology and Oncology Associates.
[AGENT][NEUTRAL] OK, I do believe I found this claim. Give me just a moment, let me verify.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] Appreciate your patience and bear with me just a moment.
[CUSTOMER][POSITIVE] Sure, take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] OK, so sorry about that wait. I appreciate your patience. I did find this claim. OK, so we paid a benefit of $133.86 for this claim.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just a moment. The only thing we were unable to pay, uh, was the office visit, as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK. May I know the claim number, please?
[AGENT][NEUTRAL] Yes, claim number is 3547.
[AGENT][NEUTRAL] 311.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and check number?
[AGENT][NEUTRAL] The check number is 2021258.
[CUSTOMER][NEUTRAL] OK. Is this a single check or?
[AGENT][NEUTRAL] It is a single check.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] OK, shoot on
[AGENT][NEUTRAL] It was issued [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. And how?
[CUSTOMER][NEUTRAL] OK, how can we get the UB?
[AGENT][NEUTRAL] Um, I can fax it to you. Do you have a fax number?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so the fax number is 855.
[CUSTOMER][NEUTRAL] 933
[CUSTOMER][NEUTRAL] 1195. I repeat one more time. It is [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Got it. OK, thank you for confirming that. I'll go ahead and send that to you now. Uh, you should get it here in maybe 10 or 15 minutes depending on how busy your machine is.
[CUSTOMER][POSITIVE] OK. Thank you so much and let's move to the next data service. For the same member.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh, give me one moment. OK, OK, give me just a moment, let me go ahead and get this sent first. um, I'll let you know when I'm ready to proceed.
[CUSTOMER][POSITIVE] Sure, sure. Take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] You did say the next claim was going to be for the same member, correct?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, um, what I just put this fax to your attention, [PII]?
[CUSTOMER][NEUTRAL] Yeah, same.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, I'm waiting for that to load. Um, I can go ahead and take that date of service for the next one.
[CUSTOMER][NEUTRAL] Sure. OK. So the next date of service is [PII] with the bill amount $974.06.
[AGENT][NEUTRAL] OK, [PII]. All right, one moment.
[AGENT][NEUTRAL] And this was the same uh provider?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Miami hematology. OK.
[AGENT][NEUTRAL] OK, this one looks identical to the other. Uh, we paid a benefit of $133.86.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And the only other thing we could not pay was the office visit um check number is 202.
[CUSTOMER][NEUTRAL] OK. And check number?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] 1256.
[CUSTOMER][NEUTRAL] And should it.
[AGENT][NEUTRAL] Oh, let me get that. Give me just a moment.
[AGENT][NEUTRAL] OK, this check was also issued, uh, around [PII].
[CUSTOMER][NEUTRAL] And what is the claim number?
[AGENT][NEUTRAL] Claim number, oh, just a moment, that is 354-729-9.
[CUSTOMER][NEUTRAL] OK, so let's move to the last date of service for this patient.
[AGENT][NEUTRAL] OK, one moment, [PII], uh, did you need, um, this other EOB as well or just the first one?
[CUSTOMER][NEUTRAL] Yeah. Yeah, yeah.
[AGENT][NEUTRAL] You needed this one as well?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I will get that pulled up and sent to you um what was the other date of service?
[CUSTOMER][NEUTRAL] Uh, the digital service.
[AGENT][NEUTRAL] The next one, yeah.
[CUSTOMER][NEUTRAL] Yeah. Uh, [PII] with the bill amount $974.06.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, this one is the same as the others as well, um, we paid a benefit of $133.86.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, I've got the check number and the claim number.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, check number is 202.
[AGENT][NEUTRAL] 125 7.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and that was, let's see.
[AGENT][NEUTRAL] This check was also issued [PII].
[CUSTOMER][NEUTRAL] This is also a single check, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Can you please fix the UV as well?
[AGENT][NEUTRAL] Yes, did you need this claim number?
[CUSTOMER][NEUTRAL] Uh, yeah, please.
[AGENT][NEUTRAL] OK, this card number is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much. And your call reference number?
[AGENT][NEUTRAL] The reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] and then was there anything else I could help you with?
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. You should be getting those faxes shortly, and I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye. Thank you.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] But