AccountId: 011433970860
ContactId: 67c12b23-3b5b-4344-89ee-0aba52a9b1d5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 394540 ms
Total Talk Time (AGENT): 173712 ms
Total Talk Time (CUSTOMER): 172447 ms
Interruptions: 7
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/67c12b23-3b5b-4344-89ee-0aba52a9b1d5_20250115T20:18_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] So that's.
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling to see if you received a claim that um.
[CUSTOMER][NEUTRAL] was submitted it would have been your secondary.
[CUSTOMER][NEUTRAL] Blue Cross Blue Shield.
[AGENT][NEUTRAL] OK. Are you calling from the provider's office or are you the insured?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] No, I'm calling from the provider's office.
[AGENT][NEUTRAL] OK, and you're wanting to see if we have received a claim that you all submitted?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, yes, ma'am. I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Thank you and so what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the patient's policy number, please, [PII].
[CUSTOMER][NEUTRAL] Um, I have it as 02233041 ML8.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][NEUTRAL] Oh that's how I think I found that guy [PII], that comedian that died, he was hysterical.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And so any information that I do provide for you today would be a verification of benefits, not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] I'm gonna go to the gym first, and then I'll be over for dinner.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] OK, and what is the date of service and total bill amount for her place?
[CUSTOMER][NEUTRAL] You know what
[CUSTOMER][NEUTRAL] [PII] and it's $20,936.
[AGENT][NEUTRAL] 2936, is that correct?
[CUSTOMER][NEUTRAL] No, 20,936.
[AGENT][NEUTRAL] Yes, 20,936, 29, well, I think I said it 2936, but yes, that's right. OK. So just one moment.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what is the facility name?
[CUSTOMER][NEUTRAL] River Walk Surgery Center.
[CUSTOMER][NEUTRAL] on.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] right now.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I didn't answer
[CUSTOMER][POSITIVE] But I did get a lot chopped off to make it healthier.
[AGENT][NEUTRAL] OK, so this claim was received soon. The received date was [PII]. I almost said [PII]. I'm still getting used to saying one is [PII]. And it was processed on [PII].
[CUSTOMER][NEUTRAL] And then.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] The claim number is 3548077.
[AGENT][NEUTRAL] And there was a benefit paid on this claim in the amount of $3,384.59.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Again, that was 3384.59.
[CUSTOMER][POSITIVE] Yes, all right, thank you.
[AGENT][NEUTRAL] And the remark on the explanation of benefits states that with this payment, with the payment of this check, the policy maximum for this.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Benefit has been met.
[CUSTOMER][NEUTRAL] Let's get.
[CUSTOMER][NEUTRAL] Um, does it say, uh, like a check number or check date or EFT number or anything?
[AGENT][NEUTRAL] OK. The check date, it's gonna be a single check.
[AGENT][NEUTRAL] That means it went through our processing the same date that I gave you. and the check number is [PII].
[CUSTOMER][NEUTRAL] or either then.
[AGENT][NEUTRAL] 1457.
[CUSTOMER][NEUTRAL] And does does it say where it was mailed like?
[CUSTOMER][NEUTRAL] By any chance?
[AGENT][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] What is the tax ID?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, great, [PII], [PII].
[AGENT][NEUTRAL] [PII] [PII]. Yes, ma'am. Uh-huh.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Perfect thank you OK um and do you give out reference numbers or?
[AGENT][POSITIVE] Well, you are very welcome and then.
[AGENT][NEUTRAL] Yes, ma'am, you would use my name that I gave you along with today's date and then if you need if you need a copy of the explanation of benefits, you can print that by going to our portal so at [PII].
[CUSTOMER][NEUTRAL] Mhm OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Am public.
[AGENT][NEUTRAL] Uh-huh, [PII].
[CUSTOMER][NEUTRAL] And I don't need to like register or anything?
[AGENT][NEUTRAL] You would set up a username and password. You just walk through the steps.
[CUSTOMER][POSITIVE] But I get immediate access.
[AGENT][NEUTRAL] And entering the information under. Mhm.
[CUSTOMER][NEUTRAL] OK, all right.
[AGENT][NEUTRAL] Yes, you would set it up under a medical or dental provider would be the option that you would select and then you just walk through the, through the steps.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, alright, thank you so much I appreciate your information.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, absolutely. You're very welcome. And is there anything else that I can help you with today?
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] OK. Well, you're welcome and thank you again for calling APL. I hope you have a very nice evening.
[CUSTOMER][POSITIVE] Thank you. You too. Bye.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.