AccountId: 011433970860
ContactId: 7ba09123-9f81-4c98-878c-43c740bb0a11
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 866799 ms
Total Talk Time (AGENT): 231069 ms
Total Talk Time (CUSTOMER): 191256 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/7ba09123-9f81-4c98-878c-43c740bb0a11_20250519T14:14_UTC.wav
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[AGENT][POSITIVE] Thank you for calling this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, my name is [PII] last name.
[CUSTOMER][NEUTRAL] And I need your assistance regarding um member eligibility.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK, I can help you with eligibility [PII]. Can I please get your callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Uh yeah.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, sure, callback number is [PII].
[AGENT][NEUTRAL] Thank you sir and what's the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Uh, sure, facility is neurology clinic at clinic specialties.
[AGENT][POSITIVE] OK, thank you sir.
[AGENT][NEUTRAL] And may I have the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] I sure.
[CUSTOMER][NEUTRAL] Uh, last name is.
[CUSTOMER][NEUTRAL] [PII] First name is uh [PII], uh sorry, [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, and then what is [PII]'s policy number, please?
[CUSTOMER][NEUTRAL] Uh, sure, it's 02514682.
[AGENT][NEUTRAL] OK, let me look that up for you real quick, [PII] so we can get you some benefit informa or some eligibility information.
[CUSTOMER][NEUTRAL] I sure.
[AGENT][NEUTRAL] OK, looking at this policy, I do see that [PII] does have an active policy. The effective date of her policy is [PII].
[CUSTOMER][NEUTRAL] Uh, no termination date, right?
[AGENT][NEUTRAL] And it's current.
[AGENT][NEUTRAL] Right, it's current.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, may I get the electronic ID?
[AGENT][NEUTRAL] Yes sir, that would be 60801.
[CUSTOMER][NEUTRAL] OK, and did you check that, uh, uh, any claim on file for service is [PII], and the charge amount of the claim is
[CUSTOMER][NEUTRAL] $385.00.
[AGENT][NEUTRAL] OK, and that date of service was [PII], is that correct?
[CUSTOMER][NEUTRAL] Uh yeah.
[AGENT][NEUTRAL] OK, alright, let me put you on.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Thank you, sir. Let me put you on a quick hold while I look up this claim for you and I'll be right back, sir.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh sure charge amount is 5. You are on hold.
[AGENT][NEUTRAL] I'm sorry, you said the charge amount was what sir?
[CUSTOMER][NEUTRAL] $5515.00.
[AGENT][NEUTRAL] OK, and the amount that you first gave me is $385 that's no longer correct?
[CUSTOMER][NEUTRAL] I yeah.
[AGENT][POSITIVE] OK, alright, thank you so much, [PII]. I'll be right back after checking the claim for you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you [PII] for holding for me. So looking on the data service of [PII], I did find the claim.
[AGENT][NEUTRAL] The claim number is 358.
[AGENT][NEUTRAL] 9505.
[AGENT][NEUTRAL] This client was paid $50.
[AGENT][NEUTRAL] After the $50 paid it maxed out the benefits for the day.
[AGENT][NEUTRAL] The check number for the claim is 203908.
[CUSTOMER][NEUTRAL] OK, uh, wait a second, ma'am, your voice.
[AGENT][NEUTRAL] And let me look up.
[CUSTOMER][NEUTRAL] Uh hello, can you hear me?
[AGENT][NEUTRAL] Hello, yes.
[CUSTOMER][NEUTRAL] OK, actually, actually, ma'am, it's a technical issue, uh, we cannot hear you. OK, do you provide me first claim receipt and purchase date?
[AGENT][NEUTRAL] Yes, I can hear you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let me look and see.
[AGENT][NEUTRAL] on [PII] and process on [PII].
[CUSTOMER][NEUTRAL] OK, and same number.
[AGENT][NEUTRAL] I'm sorry, can you repeat the question?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] And may I get the number?
[AGENT][NEUTRAL] Yes sir, the claim number is 35895005.
[CUSTOMER][NEUTRAL] OK, and may I get the uh renting provider name?
[AGENT][NEUTRAL] The provider name is the name you gave me.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Do you confirm provider's name is Doctor [PII], right?
[AGENT][NEUTRAL] I'm sorry, can you repeat that question?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Do you provide me the information of the payment?
[AGENT][NEUTRAL] Yes, the payment was paid $50.
[AGENT][NEUTRAL] With check number 203906.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] Not
[CUSTOMER][NEUTRAL] And, and do you uh one more time check number.
[AGENT][NEUTRAL] 2039068
[CUSTOMER][NEUTRAL] OK, it's a single payment and amount.
[AGENT][NEUTRAL] Single payment.
[CUSTOMER][NEUTRAL] OK, it's EFT.
[AGENT][NEUTRAL] Paper
[CUSTOMER][NEUTRAL] Is that paper?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I get the address where uh paper check was issued.
[AGENT][NEUTRAL] Can you get the
[AGENT][NEUTRAL] Address? Is that what you asked?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK, and do you provide me a total amount $50.
[CUSTOMER][NEUTRAL] Uh, can you confirm the total amount is $50. How much?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] $50 even, no cents.
[CUSTOMER][NEUTRAL] $50.00 right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and patient responsibility.
[AGENT][NEGATIVE] We don't give patient responsibility.
[CUSTOMER][NEUTRAL] OK ma'am and uh
[CUSTOMER][NEUTRAL] Do you have a payment clear date?
[AGENT][NEUTRAL] Yes, the payment date was [PII].
[CUSTOMER][NEUTRAL] Uh, OK, ma'am, and also, uh, I am.
[CUSTOMER][NEUTRAL] And CP code 94.
[CUSTOMER][NEUTRAL] 760 is paid in internet.
[CUSTOMER][POSITIVE] The second line is pretty good.
[AGENT][NEUTRAL] The payment zip code was [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, do you check that it's second line CPT code [PII] is paid and denied.
[AGENT][NEUTRAL] The CPT code? OK, let me get back over there real quick.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, I'm sorry, I thought you were asking for the zip code. I apologize.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what was the code again? Can you give it to me one more?
[CUSTOMER][NEUTRAL] Uh, security code is [PII].
[AGENT][NEGATIVE] Yes that was denied.
[CUSTOMER][NEUTRAL] OK, and may I get the?
[AGENT][NEUTRAL] The, um, it might be.
[AGENT][NEGATIVE] Because it exhausted the benefit.
[CUSTOMER][NEUTRAL] May I get your name?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] A.
[AGENT][NEUTRAL] A
[CUSTOMER][NEUTRAL] And conference number [PII].
[AGENT][NEUTRAL] You can use my name and today's date.
[CUSTOMER][POSITIVE] OK, ma'am, uh, thank you for your assistance. I really appreciate it and have a good day and bye bye.
[AGENT][POSITIVE] You too, [PII]. You have a good day. Is that everything I can help you with before we go?
[CUSTOMER][POSITIVE] Uh, no, ma'am, I really appreciate it, uh, for your place. Have a good day. Bye bye.