AccountId: 011433970860
ContactId: 681a72cf-bc16-45e2-b9e2-f4f8b9fc759a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 354720 ms
Total Talk Time (AGENT): 136560 ms
Total Talk Time (CUSTOMER): 142731 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/681a72cf-bc16-45e2-b9e2-f4f8b9fc759a_20250516T17:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, hey, [PII], my name is [PII] and I'm calling from a provider's office. How are you?
[AGENT][NEUTRAL] Doing well, [PII] how are you?
[CUSTOMER][NEUTRAL] I'm good I'm good you're breaking up a little bit so we'll try and keep the call short but um I have a I have a question um we had called I guess it was about a month ago um regarding a claim for [PII].
[AGENT][NEUTRAL] Uh oh.
[AGENT][NEUTRAL] Sorry.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh do you need the member ID?
[AGENT][NEUTRAL] Um, yes, but before that, [PII], if you don't mind, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yep, [PII] and that's my direct number.
[AGENT][NEUTRAL] OK, thank you. And then I will go ahead and take that uh policy number, please.
[CUSTOMER][NEUTRAL] Uh, it's 02293914.
[AGENT][NEUTRAL] OK, one moment please.
[AGENT][NEUTRAL] OK, and then, um, if you would, can you verify [PII]'s date of birth, please?
[CUSTOMER][NEUTRAL] Uh, it, whoops, let me get to that screen.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Perfect. OK, so I do have this policy up. Um, do you know the claim number that, uh, we're regarding that we're referring to, sorry?
[CUSTOMER][NEUTRAL] I don't, I don't I have date of service and then I also have a check number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, sure. What was that date of service, please?
[CUSTOMER][NEUTRAL] It's [PII] for a billed amount of 298.
[AGENT][NEUTRAL] OK, one moment please.
[AGENT][POSITIVE] OK, OK, I do believe I found it. We paid a benefit of uh $72 it looks like.
[CUSTOMER][NEUTRAL] Yes, and based on our past phone call about a month ago.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The rep told me and her name was [PII]. The check was dated on around [PII], but it hadn't cleared.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let's take a look there.
[AGENT][NEUTRAL] OK, yes, I am showing that the check was issued [PII] and yes it has not yet cleared, so I can absolutely get that uh voided and reissued to you um whenever you're ready I'll go ahead and verify the address we have, make sure that that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I think what you have on file is [PII], OK, [PII] and that's fine if you mail it there that's fine.
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, OK, awesome alright so I'll go ahead and have this voided and reissued then um did you have any other questions regarding this claim?
[CUSTOMER][NEUTRAL] Um, no, I just need with that obviously with that check we'll get uh the EOB, right?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, I can go ahead and send that to you now if you'd like. Do you have a fax number?
[CUSTOMER][POSITIVE] Uh, yeah, that'd be great [PII].
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 455.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Alrighty, I'll go ahead and send that now. I should get it within about 10 minutes or so. Uh, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I actually have another claim for the same patient. Um, it is, it's for date of service [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] What was the bill amount for this claim?
[CUSTOMER][NEUTRAL] Uh, for 1028 it was $1,954.
[AGENT][NEUTRAL] Got it. OK. Give me just a moment.
[AGENT][NEUTRAL] OK, so for this claim we were unable to pay any benefit as neither of those procedure codes are covered under this policy.
[CUSTOMER][NEUTRAL] OK, when you fax the other EOB, can you fax me that one as well just so that we have a record of that?
[AGENT][POSITIVE] I absolutely.
[AGENT][POSITIVE] Absolutely. I'll get both of those sent to you.
[CUSTOMER][NEUTRAL] And then um just again your name and a reference number and that that's it.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] A R A. last initial is A.
[CUSTOMER][POSITIVE] OK, alright, that sounds great. So we'll just look forward to getting those EOBs for uh 10:16 and 10/28.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Absolutely. Shouldn't be longer than about 10 minutes that you should get those.
[CUSTOMER][NEUTRAL] And, and then you.
[CUSTOMER][NEUTRAL] OK and then as far as uh voiding that check and reissuing it, when can we expect payment?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, let's see, I would say anything with mail to allow at least a couple of weeks, um, for this request to process maybe a few business days, um, but you know it's mail is always kind of a coin toss.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, yeah, alright, very good, thank you [PII].
[AGENT][POSITIVE] Yeah, absolutely