AccountId: 011433970860
ContactId: 76f4b7d9-0a9b-473a-863e-7637c6a9cdfc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 889780 ms
Total Talk Time (AGENT): 265247 ms
Total Talk Time (CUSTOMER): 202044 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/76f4b7d9-0a9b-473a-863e-7637c6a9cdfc_20250129T13:29_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office. Before proceeding, I would like to share you this call is recorded for training and quality purpose. Is it OK for you?
[AGENT][POSITIVE] I can assist you and spell your name for me?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Or or [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and you said that you're checking claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and the policy number?
[CUSTOMER][NEUTRAL] 02152688 Mike Lima number 8.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You can also check your status on the online service center at [PII].
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], sorry, [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, if I can get the date of service and the total charge.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII], with total charge $500 even.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Sure. Can you spell your name for me, please?
[AGENT][NEUTRAL] [PII], first initial last name is [PII], and you'll use my name in today's status reference for today's call.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, so I have this information for you. I'm showing that this claim was received on [PII].
[AGENT][NEUTRAL] Process [PII]. Uh, we're requesting a copy of the major medical.
[AGENT][NEUTRAL] Explanation of benefits.
[CUSTOMER][NEUTRAL] OK. Can you confirm the claim number?
[AGENT][NEUTRAL] That claim number is 354-7624.
[AGENT][NEUTRAL] And did you have any other questions for [PII]?
[CUSTOMER][NEUTRAL] Yes, actually, I have 3 more claims with different patients.
[AGENT][NEUTRAL] OK, you can also check your status on our online service center and I can help you create that account if you would like. Let me know when you're ready for the web address.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] It's secured.
[CUSTOMER][NEUTRAL] Like when we're in.
[AGENT][NEUTRAL] The web address is secured, [PII]
[CUSTOMER][NEUTRAL] Uh hello?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And when you get to that site, let me know when you're there.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Can you help me with 3 more claims, please?
[AGENT][NEUTRAL] I can. Would you like assistance in creating the account to check the claim status?
[CUSTOMER][POSITIVE] Yes, actually I have it.
[AGENT][NEUTRAL] OK, so do you want to try to search for the claim online?
[CUSTOMER][NEUTRAL] Yes, I tried.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Yes, I tried in the uh portal.
[AGENT][NEUTRAL] OK, I mean while we're on the phone.
[CUSTOMER][NEUTRAL] Uh, for to double check.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] For this claim, we send in uh primary you pay that's why I call.
[AGENT][NEUTRAL] OK, so we've completed the first status, your second status, do you want me to help you create an account so we can verify the claim status online?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and so can you repeat the web address that I that was given?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] What was the web address that I gave you? Can you tell me what you have?
[CUSTOMER][NEUTRAL] I have the portal.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm, [PII] and let me know when you get to that site.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and so what's on the home page? Can you tell me what you see on the homepage?
[CUSTOMER][NEUTRAL] Need to claim, uh need to file a claim.
[AGENT][NEUTRAL] Does it say welcome the online service center?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and to the right, do you see a login tab and a new user tab?
[CUSTOMER][NEUTRAL] After
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] click on the new user tab.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what, what does it say? Is it asking you to select which role that best describes you?
[CUSTOMER][NEUTRAL] Need to file a claim.
[AGENT][NEUTRAL] OK, what, what, where are you on the website? What does the page say when you click the new user tab? What does it say?
[CUSTOMER][NEUTRAL] Just give a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sign in or register.
[AGENT][NEUTRAL] OK, so did you click on the new user tab?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and when you click the new user tab now what does it say?
[CUSTOMER][NEUTRAL] Logins.
[AGENT][NEUTRAL] It says log in.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, that's one tab, but to the right of that it says new user, do you see that?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Click on new user.
[CUSTOMER][NEUTRAL] Actually, I have the login also.
[AGENT][NEUTRAL] You've already logged in?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Give me 1 2nd.
[AGENT][NEUTRAL] And what provider tax ID number did you use?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] have
[AGENT][NEUTRAL] And what patient account number did you enter?
[CUSTOMER][NEUTRAL] My email address
[CUSTOMER][NEUTRAL] I have the patient account number.
[CUSTOMER][NEUTRAL] In my
[AGENT][NEUTRAL] What patient account number did you enter?
[CUSTOMER][NEUTRAL] Member ID.
[AGENT][NEUTRAL] It's gonna require the patient account number that's on the claim that you're calling on.
[AGENT][NEUTRAL] It's gonna be in box 26 of the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My leg.
[AGENT][NEUTRAL] What number is in that box?
[CUSTOMER][NEUTRAL] Can you provide me the details, please?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I will call you back.
[AGENT][NEUTRAL] OK, I can go ahead and help you with the other two, but I was just gonna give you the opportunity to create the account.
[AGENT][NEUTRAL] Um, just for future reference and you can check your status online. What's the next policy number?
[CUSTOMER][NEUTRAL] 02369605. Mike Lima number 8.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Question is Ms. [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And what's the date of service and total charge?
[CUSTOMER][NEUTRAL] [PII], with total charge $500 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so we need, you said 500 was the total charge?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Can you verify the procedure code on the claim or codes on the claim?
[CUSTOMER][NEUTRAL] Yeah, sure. 76536.
[AGENT][NEUTRAL] I'm showing that a payment of $50 was processed.
[AGENT][NEUTRAL] On [PII].
[AGENT][NEUTRAL] The claim was received [PII] and that explanation was mailed on the [PII] to the address on the claim.
[CUSTOMER][NEUTRAL] When was it?
[AGENT][NEUTRAL] On the day that it was processed, or the next day after it was processed, the [PII].
[CUSTOMER][NEUTRAL] OK. It was issued, uh, cash on.
[AGENT][NEGATIVE] I'm not showing that it's been cashed.
[CUSTOMER][NEUTRAL] Can you provide me the check number?
[AGENT][NEUTRAL] 1869267
[CUSTOMER][NEUTRAL] Uh, can you take the claim back for the uh cash?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Pa.
[AGENT][NEGATIVE] I didn't understand.
[CUSTOMER][NEUTRAL] Claim number?
[AGENT][NEUTRAL] The claim number is 349-513-6.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] When was cash?
[AGENT][NEGATIVE] I don't show that the check has been cashed yet. It's still outstanding.
[CUSTOMER][NEUTRAL] So, can you escalate that to the payment team because it, it's not cash yet.
[AGENT][NEUTRAL] Yeah, we can verify whether it's clear at the bank and give you a call back.
[CUSTOMER][NEUTRAL] Can you provide me the turnaround time for this?
[AGENT][NEUTRAL] Allow 5 to 7 business days.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you, uh, can I help with one more thing?
[AGENT][NEUTRAL] The policy number?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] It would be
[CUSTOMER][NEUTRAL] 02464402.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is?
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII].
[AGENT][NEUTRAL] The date of service in charge?
[CUSTOMER][NEUTRAL] [PII], with total charge, $620 even.
[AGENT][NEUTRAL] And the procedure codes on the claim?
[CUSTOMER][NEUTRAL] 77066 MG 0279.
[AGENT][NEUTRAL] Showing that this claim uh made a payment of 257.25.
[AGENT][NEUTRAL] This claim was received.
[AGENT][NEUTRAL] [PII] processed on [PII].
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] Yes. Take number.
[AGENT][NEUTRAL] 18625997.
[AGENT][NEUTRAL] Just check cleared on [PII].
[CUSTOMER][NEUTRAL] And cash on.
[AGENT][NEUTRAL] The check cleared [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions I can assist with today?
[CUSTOMER][NEUTRAL] Claim number?
[AGENT][NEUTRAL] That claim number is.
[AGENT][NEUTRAL] 348.
[AGENT][NEUTRAL] 0364.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Yeah you too thank you so much.