AccountId: 011433970860
ContactId: 73a0ecbb-048f-44e9-9dfb-954b0582747a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 539739 ms
Total Talk Time (AGENT): 207491 ms
Total Talk Time (CUSTOMER): 140495 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/73a0ecbb-048f-44e9-9dfb-954b0582747a_20250127T17:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Sorry, I am calling for the status of 2 claims for one of our policy holders.
[AGENT][NEUTRAL] OK, I can help you with claim status. Can I please get your name and your call back number?
[CUSTOMER][NEUTRAL] Uh, yeah, uh it is [PII].
[AGENT][NEUTRAL] Hey, what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you sir and then what is the patient's name?
[CUSTOMER][NEUTRAL] Is [PII] H0 or SHOMO.
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth, please?
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] Thank you. And what is her policy number?
[CUSTOMER][NEUTRAL] 229-1069
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEGATIVE] It says the one has processed online, but I was just calling to see if it paid or denied and then the other one I'm calling about because it's not showing up on the website.
[AGENT][NEUTRAL] OK. All right. Um, what is the date of service for the insured?
[CUSTOMER][NEUTRAL] Is [PII].
[CUSTOMER][NEUTRAL] And then the first one is for [PII].
[AGENT][POSITIVE] Thank you
[AGENT][NEUTRAL] OK, so for [PII] the data service is 117 of 2025.
[CUSTOMER][NEUTRAL] Uh, well, [PII]'s the policy holder on that one. It's for [PII], one of her dependents.
[AGENT][NEUTRAL] Oh, OK, so the this data service 117 2025 is for [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, sorry.
[AGENT][NEUTRAL] OK, that's all right. What's the charge amount?
[CUSTOMER][NEUTRAL] The charge amount, give me one second here.
[CUSTOMER][NEUTRAL] I'm not sure there's no documentation submitted with this claim.
[AGENT][NEUTRAL] OK, and what is the name of the facility that you're calling for?
[CUSTOMER][NEUTRAL] This R&B insurance services.
[CUSTOMER][NEUTRAL] Or do you mean the group that I'm calling like the group that I'm calling for?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] The facility, the hospital, doctor's office, um.
[AGENT][NEUTRAL] The facility that the data service took place at.
[CUSTOMER][NEUTRAL] Oh sorry, I'm an 8.
[CUSTOMER][NEUTRAL] Um, it is the data services 1172025, but like I said, there's no documentation, so I'm not sure. Give me one second here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] We have a physician named Doctor uh [PII], I think it is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Pooreski
[CUSTOMER][NEUTRAL] But I'm not sure the actual location of it.
[AGENT][NEUTRAL] OK, thank you and [PII], you mentioned that you're an agent. What group are are you calling for?
[CUSTOMER][NEUTRAL] It is Center County government.
[AGENT][NEUTRAL] OK, do you have the group number, sir?
[CUSTOMER][NEUTRAL] It is 25755.
[AGENT][NEUTRAL] OK, let me look that up first and then we'll go and look up um Miss [PII] and see about her claim.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, you said one of the claims showed up for you. Did you get the claim number?
[CUSTOMER][NEUTRAL] Uh, yeah, the one I'm calling about the process, I have the claim number if you need that.
[AGENT][POSITIVE] OK, well, yes, that'd be helpful. Thank you so much.
[CUSTOMER][NEUTRAL] Yeah it is 3555.
[CUSTOMER][NEUTRAL] 700.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like
[AGENT][NEUTRAL] We paid $50 towards the claim. Let me look and see because it's not giving me a check number, so that means that it's still in progress. Oh, OK, let me see.
[AGENT][NEUTRAL] 700. That one was paid directly to the insured of $50.
[CUSTOMER][POSITIVE] Alrighty perfect.
[CUSTOMER][NEUTRAL] And then the second claim I had was for that same policy holder if that helps.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, OK. And is it for the insured or is this one also for [PII]?
[CUSTOMER][NEUTRAL] Um, this one is for [PII], the husband, I believe.
[AGENT][NEUTRAL] The husband, OK, let me look on that one real quick.
[AGENT][NEUTRAL] OK, do you have the claim number for that one?
[CUSTOMER][NEUTRAL] No, I do not. I have a confirmation number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, what's the confirmation number?
[CUSTOMER][NEUTRAL] I couldn't find the confirmation number on there either alrighty it is uh.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OSC 9225.
[CUSTOMER][NEUTRAL] I think that's an no it might be a 0.
[AGENT][NEUTRAL] OK. I'm not finding that confirmation number on him. What was the date of service for him?
[CUSTOMER][NEUTRAL] It was uh [PII].
[AGENT][NEUTRAL] OK, let me see if I can find it by the data service.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] OK, I'm not showing that it has processed yet for [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For, for him.
[CUSTOMER][NEUTRAL] That one,
[CUSTOMER][NEUTRAL] OK, I submitted that one on the [PII]. Should I resubmit it?
[AGENT][NEUTRAL] On the [PII] you submitted it?
[CUSTOMER][NEUTRAL] Yeah, yep, OK, never mind that was only last Thursday.
[AGENT][NEUTRAL] Yes,
[AGENT][NEUTRAL] Yes sir, um, yeah, it takes 7 to 10 business days for them to process it.
[AGENT][NEUTRAL] So you, you may wanna uh.
[AGENT][NEUTRAL] Let's see, the [PII] was on Thursday, so Friday, [PII], yeah, it's only been.
[AGENT][NEUTRAL] Actually 2 business days, so that's why I'm not able to find it yet, um.
[AGENT][NEUTRAL] For for myself to be able to give you information for it so it takes 7 to 10 business days. I would call back if it give it the 10 days, the business days to process.
[AGENT][POSITIVE] And if and check on it then and if we still haven't received it then yes I would definitely resubmit it.
[AGENT][NEUTRAL] But I'm not showing that our
[CUSTOMER][NEUTRAL] Alrighty and then that is the last one I had.
[AGENT][NEUTRAL] OK, yeah, cause I'm not showing that anything's been reported since [PII] on him.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty, alright then I will keep checking on that.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] OK, [PII], we appreciate you calling and helping the customer. Thank you so much.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Of course, thank you for all your help today.
[AGENT][POSITIVE] All right. You're welcome. You have a blessed day. Thanks for calling APL, sir.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][NEUTRAL] Bye-bye, sir.
[CUSTOMER][NEUTRAL] Bye.