AccountId: 011433970860
ContactId: 70ad10c7-c988-4c2c-9425-041c0116e13d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 371350 ms
Total Talk Time (AGENT): 94745 ms
Total Talk Time (CUSTOMER): 106010 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/70ad10c7-c988-4c2c-9425-041c0116e13d_20250327T21:22_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]. This is [PII] calling from provider's office and looking on a claim status.
[AGENT][NEUTRAL] OK, do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] And patient policy number?
[CUSTOMER][NEUTRAL] Yeah, the patient's policy number is 02559264.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth, [PII].
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] [PII] for $302 even.
[AGENT][NEUTRAL] And you said it was for 210 even, is that correct?
[CUSTOMER][NEUTRAL] Uh, no, 302.
[AGENT][NEUTRAL] Oh, OK, sorry.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Who was the provider on that?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, it looks like um we processed that and made a payment of 6149.
[CUSTOMER][NEUTRAL] OK. May I know when the claim was received?
[AGENT][NEUTRAL] Um, that was received.
[AGENT][NEUTRAL] Received on [PII], paid on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And uh one paid amount is $61.49. And uh
[CUSTOMER][NEUTRAL] What about the office the zip code?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] What about the office the ZIP code [PII]?
[AGENT][NEGATIVE] Um, that was not paid. That's not a covered service. The office visit itself is not covered under the policy.
[CUSTOMER][NEUTRAL] And the meddling gap policy.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] OK. Under meddling policy, the office visit is not covered, am I right?
[AGENT][POSITIVE] Yes, that's right.
[CUSTOMER][NEUTRAL] And it's a patient responsibility?
[AGENT][NEUTRAL] Um, we don't determine patient responsibility. This is a secondary policy.
[CUSTOMER][NEUTRAL] OK. And uh may I know the payment information?
[AGENT][NEUTRAL] The check number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 203-2026
[CUSTOMER][NEUTRAL] And it's a single check or a bulk check?
[AGENT][NEUTRAL] Single trip
[CUSTOMER][NEUTRAL] May I know the issue date?
[AGENT][NEUTRAL] Issue date was [PII].
[CUSTOMER][NEUTRAL] And cashed it.
[AGENT][MIXED] Um, I show it's outstanding, but we would have to wait 30 days before we can.
[CUSTOMER][NEUTRAL] How many days?
[CUSTOMER][NEUTRAL] OK. 30 business days.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And if you'll be also sent to the provider's office with the check.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] May I have the claim number?
[AGENT][NEUTRAL] The claim number is.
[AGENT][NEUTRAL] 3573715
[CUSTOMER][NEUTRAL] 3573715.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Can you fax me the EOB?
[AGENT][NEUTRAL] Yes, what's your fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Is there anything else I can help with today?
[CUSTOMER][NEUTRAL] Uh, yes, one moment. And when we will receive the fax?
[AGENT][NEUTRAL] Yes, I'll I'll fax that in just a moment.
[AGENT][NEUTRAL] Are you wanting to check on any other claim statuses?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][NEUTRAL] OK, just to confirm your fax, it's [PII]?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, I'm getting that faxed right now so you should receive it in just a few moments.
[CUSTOMER][NEUTRAL] OK. Can you spell your name for me?
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] And for reference number?
[AGENT][NEUTRAL] Uh, my, my first name, last initial, today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much for the information you provided me on this call.
[AGENT][POSITIVE] OK, thank you so much and thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] You too as well. Thank you. Bye.