AccountId: 011433970860
ContactId: 70461601-4e37-4479-8040-75da9b9346e7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 372510 ms
Total Talk Time (AGENT): 149942 ms
Total Talk Time (CUSTOMER): 123488 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/70461601-4e37-4479-8040-75da9b9346e7_20250221T17:03_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]. My name is [PII]. How are you today?
[AGENT][POSITIVE] I'm good [PII] how are you today? this Friday?
[CUSTOMER][POSITIVE] I'm, I'm doing well, thank you for asking. I was calling in regards to two claims for a patient.
[AGENT][NEUTRAL] OK, calling for claim status. I can assist you. What is your callback number if we were disconnected?
[CUSTOMER][NEUTRAL] [PII] and there's no extension excuse me.
[AGENT][POSITIVE] OK, thank you very much. What is the policy number please?
[CUSTOMER][NEUTRAL] 00604715
[AGENT][POSITIVE] OK, and to repeat, I have that as 00604715. Thank you.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you and verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you and you're calling again for claim status. Give me one second please, [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Of course
[AGENT][NEUTRAL] OK, and did you say you have 2 dates of service for the member?
[CUSTOMER][NEUTRAL] Um, it's just one. I'm sorry. The other one is from this year.
[AGENT][POSITIVE] OK, no, OK, no problem, no problem. I'm ready for that date of service and the total charge amount please.
[CUSTOMER][NEUTRAL] It is going to be for [PII], and the amount is going to be $6,104.41 dollars. I'm sorry.
[AGENT][NEUTRAL] OK, no problem. OK, that was [PII] $6,141. OK, one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] OK, almost there, thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] physical therapy. Thank you.
[CUSTOMER][NEUTRAL] And that's all. So what, what is, what is the call?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] If you can also verify the procedure codes bill for the service date for the member, I just wanna make certain of that.
[CUSTOMER][NEUTRAL] Yes, it's 015002102950 for tooth number 443466245 for tooth number 5 6740 for tooth number 46,740 for tooth number 67,210 for tooth number 5 and 7953 for tooth number 5.
[AGENT][POSITIVE] Thank you, thank you very much.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, it shows that we received a claim and we made a payment in the amount of $241. I have both the claim number.
[AGENT][NEUTRAL] The claim and check numbers please.
[CUSTOMER][NEUTRAL] OK and when did you all um.
[CUSTOMER][NEUTRAL] Make the payment?
[AGENT][NEUTRAL] Received the claim? OK one moment.
[AGENT][NEUTRAL] OK, that claim was processed on.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the payment?
[AGENT][NEUTRAL] A payment amount of $241.
[CUSTOMER][NEUTRAL] On the same day?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And was it mailed to us or to the patient?
[AGENT][NEUTRAL] It was mailed to the provider. I can verify that mailing address one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We have [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and how long should we wait before we request to have it resubmitted because you don't have it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it has been more than 30 days so that request can um go in today if you would like, of course.
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So that is check number 2,019,840. I will make a request to have that check voided.
[AGENT][NEUTRAL] And reissue a new check reissued again that's check number 2,019,840 and that check amount $241.
[AGENT][NEUTRAL] And that was paid under claim number 3544879.
[CUSTOMER][POSITIVE] Awesome thank you so much. I truly appreciate it. Is there a reference number for our call?
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] You're welcome, [PII]. We do not provide reference numbers. You can also check claim status by visiting our secure portal at [PII], but for the reference you can use my name and today's date. Again, my name is [PII], last initial is [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you so much, [PII]. I truly appreciate it. Hope you have a great rest of your day and a wonderful weekend.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] And you as well [PII] and thank you for calling APL and take care.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye bye.