AccountId: 011433970860
ContactId: 7ecd141c-4450-4550-b3b8-07674b9928b1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1018000 ms
Total Talk Time (AGENT): 235369 ms
Total Talk Time (CUSTOMER): 251917 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=-1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/7ecd141c-4450-4550-b3b8-07674b9928b1_20250401T13:23_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] Hello, this is [PII], and I'm calling from the provider's office to check on the claim status. Can you please repeat your name once again for me?
[AGENT][NEUTRAL] Sure. My name is So. That's [PII]. And may I have the spelling of your name?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Sure, so the name is [PII]. It is spelled as [PII].
[AGENT][NEUTRAL] OK, thank you. May I have a callback number just in case we get disconnected, Mr. [PII]?
[CUSTOMER][NEUTRAL] Sure, the callback number is [PII]. It's a direct line phone number, no extensions.
[AGENT][NEUTRAL] OK, and may I have the name of the facility you're calling from for my notations?
[CUSTOMER][NEUTRAL] Sure, it is [PII].
[CUSTOMER][NEUTRAL] 504
[AGENT][NEUTRAL] OK, thank you. What is the patient's policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] 296.
[CUSTOMER][NEUTRAL] Sure, sure. The policy ID of this patient, it is 00971141.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Sure. The patient's first name is [PII] and the last name is [PII], and the date of birth of the patient, it is [PII].
[AGENT][POSITIVE] OK perfect thank you.
[AGENT][NEUTRAL] And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, so I have um two dates of service. The date of service is the same, but the amount is different. The first date of service I'm looking for is [PII] for the total charge amount billed $1,069 even $1069.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so 1,069. Let me check on this one.
[AGENT][NEUTRAL] What is the remaining amount, do you know?
[CUSTOMER][POSITIVE] Sure, please take your time.
[CUSTOMER][NEUTRAL] Uh, can you please repeat?
[AGENT][NEUTRAL] Do you know what's the remaining amount out of that 1,069?
[CUSTOMER][NEUTRAL] Uh, yeah, yep, I do. The remaining amount, it is $158.82 158.82.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Perfect one moment.
[AGENT][NEUTRAL] OK, I'm waiting on the explanation of benefits to pull up. It's gonna be a minute.
[AGENT][NEUTRAL] It looks like we did send the payment.
[CUSTOMER][POSITIVE] Sure. Sure, sure. Please take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so it looks like it was processed on [PII] and we send a benefit amount of $158.82 to the provider.
[CUSTOMER][NEUTRAL] All right. And can you please help me with the claim received date?
[AGENT][NEUTRAL] Yes, bear with me just a second, that's not on the EOB.
[CUSTOMER][NEUTRAL] Yeah. Bye.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] 3959.
[AGENT][NEUTRAL] Yeah, it was received on [PII].
[CUSTOMER][NEUTRAL] [PII] it was processed on [PII] and uh the allowed amount and paid amount is $158.82. And can you please help me with the claim number?
[AGENT][POSITIVE] That is correct.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, the claim number is 3573959.
[CUSTOMER][NEUTRAL] 59. All right. And uh can you please uh help me with the uh mode of payment, how it, how it was paid via check or EFT?
[AGENT][NEUTRAL] It's a single check paper check?
[CUSTOMER][NEUTRAL] All right. And what is the check number?
[AGENT][NEUTRAL] Check number is 203.
[AGENT][NEUTRAL] 2336.
[CUSTOMER][NEUTRAL] 203-233-6, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And um uh was it a bulk check or a single check?
[AGENT][NEUTRAL] The single check a paper check.
[CUSTOMER][NEUTRAL] Single check of $158.92. And can you please just uh confirm the address where it was sent to?
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] All right. That is the correct address. And uh can you please help me with the issue date and clear date of this check?
[AGENT][NEUTRAL] It's issued recently, so we're not gonna have a clear date, um, but it was issued the same day it was processed, [PII].
[CUSTOMER][NEUTRAL] [PII], you're stating?
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] [PII], no clear date. All right. And as I can see, we have not received uh any EOB from your side. Uh, if it is possible, can you fax us the EOB? Is that possible?
[AGENT][NEUTRAL] Yes, um, what is the fax number?
[CUSTOMER][NEUTRAL] Sure, the fax number it is [PII] and you can use my name as an attention.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said you had another one?
[AGENT][NEUTRAL] For this same member.
[CUSTOMER][NEUTRAL] Uh yup, I do. The same, the data service is same. Yes, the same number, same data service.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh should I tell you the total charge amount?
[AGENT][NEUTRAL] Yes, so if I have to fax them, I can fax them both.
[AGENT][NEUTRAL] So go ahead.
[CUSTOMER][NEUTRAL] Yes, exactly. OK. So, the next bill amount is $1,671.96. 1671.96.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, what's the remaining balance?
[CUSTOMER][NEUTRAL] The remaining balance is $571 571 dollars.
[AGENT][NEUTRAL] 571.
[AGENT][NEUTRAL] OK, let me try this one.
[AGENT][NEUTRAL] Probably don't have that one. Let's see.
[AGENT][NEUTRAL] OK, um, can you check on the total bill amount and the remaining again because I have another one, but it's, that's not the information on it.
[CUSTOMER][NEUTRAL] OK, so the total charge amount bill on this one is 1671.96 and the balance is $571 571 dollars.
[CUSTOMER][NEUTRAL] Is this what you have?
[AGENT][NEUTRAL] Let me look at the usual claim, bear with me just a second.
[CUSTOMER][POSITIVE] Sure, sure. Please take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I don't have
[AGENT][NEUTRAL] OK, um, do you mind holding for me? I'll have to check with the claims department on this one.
[CUSTOMER][POSITIVE] Sure. Sure, sure, please take your time. Yes, please. Surely one, please.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK, so, um, for this one, the last one we mentioned that one needs to be reprocessed, so that one we're, we're not, we don't have any information, you can just put that it's been reprocess, OK?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, all right, got it. Uh, so basically it was received, right? The claim was received to you guys.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yes, it was received um the same date as the other [PII].
[CUSTOMER][NEGATIVE] Oh, all right, got it, and it was still not processed.
[AGENT][NEUTRAL] It is being reprocessed. It was processed, but now it's been reprocessed. Yeah.
[CUSTOMER][NEUTRAL] That is
[CUSTOMER][NEUTRAL] All right, all right, got it. And uh was there any claim number generated on that one or um uh was it just uh.
[CUSTOMER][NEUTRAL] Like blank.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, it's gonna be under, let me tell you what's the number that it's gonna be under, um, which if it's reprocessed more than likely that number is gonna change, um.
[CUSTOMER][NEUTRAL] Uh, that's totally fine. I just have to mention that on the notes for my documentation.
[AGENT][NEUTRAL] OK, so, uh, let's see it was looks claim number 357-5216.
[CUSTOMER][NEUTRAL] 521-6 all right and uh what will be our turnaround time when uh should we call the next time?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, usually the reprocess takes 24 business hours for it to be reprocessed. Um, so I would say next week, like probably by Wednesday.
[AGENT][NEUTRAL] You should have something.
[CUSTOMER][NEUTRAL] All right, got it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Uh, 7 to 87 to 8 days, that's totally fine. OK.
[AGENT][NEUTRAL] Hm. Yeah, 24 to 48 hours, business hours, mhm, yes.
[CUSTOMER][NEUTRAL] Yeah, alright, got it. So we will call when the team will be reprocessed and what will be your call reference number for our conversation right now?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We don't have a reference numbers you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] All right, sir. Got it. I guess I know that will be all. Thank you so much for helping me out with the information today. You have a wonderful day ahead.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You as well, Mr. [PII] thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.