AccountId: 011433970860
ContactId: 79f78556-10a9-4aa1-9254-f441d0d972ec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 432570 ms
Total Talk Time (AGENT): 201961 ms
Total Talk Time (CUSTOMER): 90288 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/79f78556-10a9-4aa1-9254-f441d0d972ec_20250529T17:00_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling for claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing to get claim status, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And what is a good callback number for you please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check status on today?
[CUSTOMER][NEUTRAL] Just one
[AGENT][NEUTRAL] OK, and what is that member's policy number?
[CUSTOMER][NEUTRAL] It is 02567400.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] His name is [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] What is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] The the service is for [PII]. So the charge is $220.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do show that this claim was received on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 357-767-4.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $50.
[AGENT][NEUTRAL] And that was on check number.
[AGENT][NEUTRAL] 203.
[AGENT][NEUTRAL] 3828.
[AGENT][NEUTRAL] I do show that this check cleared on [PII].
[AGENT][NEUTRAL] And the remark on the claim, [PII] states with this check, the maximum benefit payable for this state of service has been met.
[CUSTOMER][POSITIVE] The maximum benefit.
[AGENT][NEUTRAL] Mhm. For this state of service, for this state of service.
[CUSTOMER][NEUTRAL] You say for this claim?
[CUSTOMER][NEUTRAL] For this
[AGENT][NEUTRAL] Has been met.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have a loud amount?
[AGENT][NEUTRAL] This is a limited benefit plan. It is not major medical insurance. So the $50 benefit that was paid is the maximum benefit payable for this data service.
[CUSTOMER][NEUTRAL] OK, it's a limited plan.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This insurance is a limited benefit plan. It is a hospital indemnity limited benefit plan. It is not major medical insurance.
[CUSTOMER][NEUTRAL] OK, so I have um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so, um, the paid amount is $50. The check number, it is 2,033,820, the single payment.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 382. No, the check is, the last number on the check is a 0. I mean an 8, not a 0. So it's 203-382-8.
[CUSTOMER][POSITIVE] And it was cleared on.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] 28. OK. And it's cleared on [PII]. Can you also provide to me.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] The mailing address where the check was mailed to?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, thank you. Is it possible I can receive a copy of the EOB?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Uh, yes ma'am, you can actually, you should be able to print it directly from our portal. I'll fax you this one, but for future reference we our portal website [PII] is secured.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And for any claims that we process you.
[CUSTOMER][NEUTRAL] OK, you say secured
[AGENT][NEUTRAL] Mhm, go ahead.
[CUSTOMER][NEUTRAL] OK, thank you. No no, thank you.
[AGENT][NEUTRAL] OK, so give me just a moment to get the explanation of benefits pulled up and I will fax you this one.
[CUSTOMER][POSITIVE] OK appreciate it.
[AGENT][POSITIVE] Oh, you're welcome.
[AGENT][NEUTRAL] And will it need to be faxed to your attention or is that not necessary?
[CUSTOMER][NEUTRAL] Yes, so, no, yes, to my E R I [PII]
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] You can go ahead and give me the fax number while this is still loading.
[CUSTOMER][NEUTRAL] OK, it's the same as my phone number [PII].
[AGENT][NEUTRAL] OK, does it come to your email?
[CUSTOMER][NEUTRAL] Those effects.
[AGENT][NEUTRAL] But are you able to receive fax while you're on a call?
[CUSTOMER][NEUTRAL] Oh, yes.
[CUSTOMER][NEUTRAL] Yes, it'll it'll go through. I just don't have to just don't answer it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, all right, because I know sometimes it won't transmit, you know, when.
[AGENT][NEUTRAL] When you're on a call, it won't come through. OK, so just one moment.
[AGENT][NEUTRAL] And again, that's [PII]. Correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK. Well, I have just faxed that to you, [PII], so it'll take a few minutes, but you should be receiving that very soon, provided that you're able to.
[CUSTOMER][NEUTRAL] OK, may I have a call reference number?
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Yes ma'am, you would use my name that I gave you along with today's date.
[AGENT][NEUTRAL] And is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, ma'am, that'll be it.
[AGENT][POSITIVE] OK, well then, thank you again for calling APL and I hope you have a wonderful afternoon.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You do the same thanks. Goodbye.
[AGENT][POSITIVE] Thank you. Bye-bye.