AccountId: 011433970860
ContactId: 6ac9eb98-b662-41cd-a6a0-284c193ce67e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 445320 ms
Total Talk Time (AGENT): 193934 ms
Total Talk Time (CUSTOMER): 175105 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/6ac9eb98-b662-41cd-a6a0-284c193ce67e_20250501T17:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, um, this is [PII]. I need to get information on claims please. Did you say you're [PII]?
[AGENT][NEUTRAL] Uh, [PII]
[AGENT][POSITIVE] And then yes I can definitely check on a claim for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII] direct.
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, that is 02.
[CUSTOMER][NEUTRAL] 483108
[AGENT][NEUTRAL] Got it. And what was the name and date of birth for this member, please?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Do you have that build out?
[CUSTOMER][NEUTRAL] $373 even no cents.
[AGENT][NEUTRAL] Got it. OK. And now was that the amount before or after major medical paid?
[CUSTOMER][NEUTRAL] That's the total charges, uh, the same, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, one moment.
[CUSTOMER][NEUTRAL] What do you need to know about the other?
[AGENT][NEUTRAL] That's OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yeah, so we did receive this claim, um, and we were, uh, we're missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] OK, do you have a fax number that I can send that to you?
[AGENT][NEUTRAL] Absolutely, uh, that is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] And I would just put attention claims.
[AGENT][NEUTRAL] Times department, yes.
[CUSTOMER][NEUTRAL] OK, and for that you will not need new bill for, you just need the explanation of benefits, correct?
[AGENT][NEUTRAL] Primary, yes, just essentially showing, uh, attributed to co-pay, deductible or co-insurance.
[CUSTOMER][NEUTRAL] OK, we're, um, our phone is, is breaking up. I don't know if I am for you as well. So the number I heard is 877.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] 3659423
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, we'll, we'll get that to you, [PII]. Can I have a reference for this one?
[AGENT][POSITIVE] All right, sounds good.
[AGENT][NEUTRAL] To be my first name, last initial, and today's date. Uh, my last initial is there wasn't anything else I could help you with?
[CUSTOMER][NEUTRAL] Is it the last initial [PII] you said?
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] OK, this phone is crazy alright um no, I have one more patient please.
[AGENT][NEUTRAL] I.
[AGENT][NEUTRAL] OK, um, one moment, I'll let you know when I'm ready for that next policy number.
[CUSTOMER][NEUTRAL] It's like you're underwater. It's like it's.
[AGENT][NEUTRAL] Oh weird.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Yes, one moment please.
[CUSTOMER][NEUTRAL] And I'm coming and you can hear me OK.
[AGENT][NEUTRAL] I can hear you perfectly fine, so maybe it's my mic. I'm not sure.
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] I think you're practicing talking while you're gargling.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] I'm not, um, that'd be interesting though.
[AGENT][NEUTRAL] Uh, and I'm very sorry if that's what it sounds like. That sounds terrible.
[CUSTOMER][NEUTRAL] That's what it sounds like, OK.
[AGENT][NEUTRAL] OK, um, what was that next policy number?
[CUSTOMER][NEUTRAL] OK, the next one reads um.
[CUSTOMER][NEUTRAL] 02478991 M Mary L Lima 8.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for this number?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, and then that uh date of service please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right. And then that bill out, please.
[CUSTOMER][NEUTRAL] $762 even.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, I'm not showing that we received a claim for that amount. Yeah. Do you have that amount left over after major medical paid?
[CUSTOMER][NEUTRAL] Um, yes, it is.
[CUSTOMER][NEGATIVE] Well, they didn't pay anything actually they applied everything to the patient's co-pay which was $48.25.
[AGENT][NEUTRAL] Got it. OK, so that is the claim that we received for this state of service. One moment, and we did pay that benefit of $48.25. Um, I've got that claim number and that check number if you need that.
[CUSTOMER][NEUTRAL] OK. What's the claim number?
[AGENT][NEUTRAL] That is 3541052.
[CUSTOMER][NEUTRAL] OK, and then you, it was paid by a is it a single check?
[AGENT][NEUTRAL] And then that check, mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, the number?
[AGENT][NEUTRAL] That that is 2018536.
[CUSTOMER][NEUTRAL] 2018536. OK, we don't have this. What's the date of the issue of the check?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, um, so the issue date was, yeah, it's, uh, [PII], and I am showing that it is still outstanding it has not cleared, so I can get this voided and reissued. Let me confirm the mailing address that we have whenever you're ready.
[CUSTOMER][NEUTRAL] By chance recent?
[CUSTOMER][NEUTRAL] Um, sure, go ahead.
[AGENT][NEUTRAL] I have [PII].
[CUSTOMER][POSITIVE] That's the right place.
[AGENT][NEUTRAL] OK, OK, so I'll get this alrighty I'll get this voided and reissued to y'all. Uh, did you need a copy of this EOB or anything?
[CUSTOMER][POSITIVE] That address is correct, OK.
[CUSTOMER][NEUTRAL] Um, yeah, if you can, could you fax it to me?
[AGENT][POSITIVE] Absolutely, what's that fax number for you?
[CUSTOMER][NEUTRAL] Mhm that's [PII]?
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][POSITIVE] That's correct.
[AGENT][POSITIVE] Alright, I will go ahead and get that sent now. I should get it within about 10 minutes or so. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, great.
[CUSTOMER][NEUTRAL] No, since you're gonna have to do the reissue and void, well that, that will take some time, right, about maybe 30 days or 45, OK, alright.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I would say 30, uh, yeah, I would say closer to 30.
[CUSTOMER][POSITIVE] OK, excellent, thank you for your help.
[AGENT][POSITIVE] Of course, thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] OK, you as well. Bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.