AccountId: 011433970860
ContactId: 6809c461-ee80-4051-b472-e0b7aeadea6d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 280799 ms
Total Talk Time (AGENT): 99598 ms
Total Talk Time (CUSTOMER): 97536 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/6809c461-ee80-4051-b472-e0b7aeadea6d_20250227T18:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm here to check on claim status today.
[AGENT][NEUTRAL] OK, I can check on a claim for you. You said your name was [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] And your name is [PII], right?
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh, [PII], it's uh [PII]
[CUSTOMER][NEUTRAL] Yeah I get.
[AGENT][NEUTRAL] And then, uh, did you, did you have that policy number?
[CUSTOMER][NEUTRAL] Yes, it's 02544684.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And then what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Member's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Data service is [PII] for the total charges of $691 even.
[AGENT][NEUTRAL] 91. OK, thank you. One moment please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, they stay at home.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, TJ, I'm sorry, what was the name of the provider's office this was with?
[CUSTOMER][NEUTRAL] Yes, the office is Norton Community Medical Associates.
[AGENT][NEUTRAL] OK, thank you for that. Um, so we did receive this claim, uh, we paid a benefit of $50 which was the maximum amount payable for the state of service.
[CUSTOMER][NEUTRAL] OK. So, may I know what is about the remaining balance?
[AGENT][NEUTRAL] Uh, one moment, let's see.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] I'm on it right now.
[AGENT][POSITIVE] OK, so we pay, oh goodness.
[AGENT][NEUTRAL] So we paid that benefit of $50 the amount that we couldn't pay of course from the remaining amount was uh $641 we don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] It is on patient responsibility, but it's up to the provider, right?
[AGENT][NEUTRAL] We don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, but, uh, without the information, we couldn't process now and.
[CUSTOMER][NEUTRAL] Do you have any other informa without any information, we could not build anyone. So could you please, uh, do you have any other sort of information about this?
[AGENT][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] I could send you a copy of the EOB.
[CUSTOMER][NEUTRAL] Yeah, but previously also you have received an EOB, uh, but there is no information about in the EOB as well.
[AGENT][NEUTRAL] And the only other information I could provide is that EOB um that shows we paid a benefit of $50.
[CUSTOMER][NEUTRAL] OK, so could you please provide me that UB through fax?
[AGENT][NEUTRAL] Sure, what's that fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I will get that sent to you. You should get it here in maybe 1015 minutes depending on how busy your machine is. Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the call reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII]
[CUSTOMER][POSITIVE] OK. So thank you for assisting me today. Have a nice day.
[AGENT][NEUTRAL] Of