AccountId: 011433970860
ContactId: 78d83a0d-1abf-45b5-ad54-2138cad74260
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 333279 ms
Total Talk Time (AGENT): 162072 ms
Total Talk Time (CUSTOMER): 101816 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/78d83a0d-1abf-45b5-ad54-2138cad74260_20250219T16:02_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], and do you spell that [PII]?
[AGENT][NEUTRAL] Yes, last initial [PII]
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, thank you. Uh, my name is [PII]. I'm calling for claim status.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, Ms. [PII]. May I have a callback number just in case we get disconnected and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and where are you calling from?
[CUSTOMER][NEUTRAL] I am calling from uh Chris's Mother Francis Hospital.
[AGENT][NEUTRAL] OK, thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] The patient's number is 02449038.
[AGENT][NEUTRAL] Thank you. What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, perfect, thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] 1 1225 for $670.
[AGENT][NEUTRAL] All right, let me see if I can find this claim for you. And for future, you can check claim status online through our website at [PII] and that's just optional.
[AGENT][NEUTRAL] And here it is. Let me pull the EV one moment.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] How's your morning going so far?
[AGENT][POSITIVE] It's good, it's good. It's cold, and this heater it's just not cutting it, but
[AGENT][POSITIVE] It'll get better. Um.
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] Alright
[AGENT][NEUTRAL] All right, here we go.
[AGENT][NEUTRAL] How about yours?
[CUSTOMER][NEUTRAL] How about you?
[CUSTOMER][POSITIVE] It's going pretty good. It's going pretty good, yes, ma'am.
[AGENT][NEUTRAL] called
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] Good, good.
[CUSTOMER][NEUTRAL] A little cold like you said.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But you just have to bundle up and keep pushing forward.
[AGENT][NEUTRAL] That's right, that's right. OK, so it looks like we already processed that claim on [PII] and we send a benefit amount of $25 to the provider and it looks like that's gonna be the um maximum, let me check, uh, yes, with the check, the maximum benefit payable for the date of service has been met.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And you said pay $25?
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] OK, and when was it received?
[AGENT][NEUTRAL] Um, let me check and see.
[AGENT][NEUTRAL] It was received [PII].
[CUSTOMER][NEUTRAL] OK, I see [PII] and you said it processed [PII]. OK, and was that um payment on an EFT or?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] It was a check, a single check.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, and the check number, ma'am?
[AGENT][NEUTRAL] The check number is 2023577.
[CUSTOMER][NEUTRAL] OK, and so the balance is going to be, uh, is there any patient responsibility?
[AGENT][NEUTRAL] And this is not a major medical, so we don't have patients responsibility. Um, it's just not payable by the policy, so yeah, so it's up to the provider's discretion.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, got you, um, all right, and you said that was a single check, um, and what was it sent to?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me get that information one moment.
[AGENT][NEUTRAL] OK, so it was sent to
[AGENT][NEUTRAL] the first page.
[AGENT][NEUTRAL] Let me pull the first page one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so it's going to
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, perfect. OK. And the claim number?
[AGENT][NEUTRAL] OK, the claim number is 3553535.
[CUSTOMER][NEUTRAL] 3553535. OK, so 3553535. OK, and is there a reference number you can give me for today's call?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] Yes ma'am. OK, well thank you so much. I hope you stay warm and have a great rest of your day.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome. Thank you. You as well. Have a good day and thank you for calling APM Miss [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] Bye bye.