AccountId: 011433970860
ContactId: 6a59bb79-559b-4d88-86f8-3871e5bd7535
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 522039 ms
Total Talk Time (AGENT): 118561 ms
Total Talk Time (CUSTOMER): 164398 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/6a59bb79-559b-4d88-86f8-3871e5bd7535_20250506T19:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm [PII]. I'm calling from Marshall Chiropractic office about our mutual patient [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I, I'm calling to see um what the payment status would be for claim for bills that were sent in for um [PII], [PII], and [PII].
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with claim status. Um, first, could I get your name again and a good callback number?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Um, 023488888.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], and his date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Um, now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The date, first date of service um was for [PII] and it was for $55.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Yes, ma'am. We received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim number is
[CUSTOMER][NEUTRAL] For
[AGENT][NEUTRAL] OK. Um, the claim number is 356-6792.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm showing that it paid out for $150.
[CUSTOMER][NEUTRAL] And that was on [PII]?
[AGENT][NEUTRAL] Yes, ma'am. [PII] for Marshall Chiropractic Life Center.
[CUSTOMER][NEUTRAL] OK, hm.
[CUSTOMER][NEUTRAL] And it paid out at $150.
[AGENT][NEUTRAL] Yeah, but I'm showing that the bill charges are 55. 1 moment, let me take a look at the image.
[CUSTOMER][NEGATIVE] Right, that doesn't make sense to me.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] That could be maybe for the [PII] payment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because we do show that we got paid $150 for that.
[AGENT][NEUTRAL] OK, I'm showing this is on the [PII] claim now, see, mm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Yes, ma'am, and I apologize. What I would need to do is send this claim back to processing for it to be reviewed again.
[AGENT][NEUTRAL] Because I'm not, um, yeah, I'm not showing where it should have paid out for the 150. And you said you had another claim?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Or is this the only one?
[CUSTOMER][NEUTRAL] The other claim that paid out at 150 was on [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it paid 150.
[AGENT][NEUTRAL] And that one paid out correctly?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Uh, yes, that one paid out correctly. It was for the bill, the total bill was for.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have to add this up here. Just give me a second, um.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 2055.
[CUSTOMER][NEUTRAL] 5.
[CUSTOMER][NEUTRAL] The total bill was for 400.
[CUSTOMER][NEUTRAL] And they paid 150.
[AGENT][NEUTRAL] Mm OK. OK. Yes, ma'am. I'll send this one back.
[CUSTOMER][NEUTRAL] Because that was for uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Yeah, I'm sorry.
[CUSTOMER][NEUTRAL] And what about on um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] On [PII] we just received back um and we've received these before and I never know quite what to do with them um.
[CUSTOMER][NEUTRAL] Where they say they're or they're waiting for to confirm eligibility from benefits in a card.
[CUSTOMER][NEUTRAL] So what does that mean for us?
[AGENT][NEUTRAL] OK, yeah, it's just that the claim is still pending. Benefits is in a card, they assist us with processing these claims.
[CUSTOMER][NEUTRAL] OK, alright.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Alright, because that's what I got for the [PII] also was the same thing, so.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know. OK.
[CUSTOMER][NEUTRAL] Yeah, it's, do you show on um [PII] that we got $150?
[AGENT][NEUTRAL] Now, let me look that up.
[AGENT][NEUTRAL] Yes, ma'am. I do show that for [PII].
[CUSTOMER][NEUTRAL] OK, all right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Yeah, so like I said, I'll send this one back to be reviewed and reprocessed.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Uh, nope, um, that will be all. I appreciate your help.
[AGENT][POSITIVE] OK, thank you, [PII], for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you you also bye.
[AGENT][POSITIVE] Mm, thank you.