AccountId: 011433970860
ContactId: 80efdbb0-ebd4-4673-b6c2-41bd2c7dbf1e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 446089 ms
Total Talk Time (AGENT): 219789 ms
Total Talk Time (CUSTOMER): 137534 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/80efdbb0-ebd4-4673-b6c2-41bd2c7dbf1e_20250513T15:09_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII]. I'm calling from provider's office. I just called to know the claim status.
[AGENT][POSITIVE] OK, [PII], I'll be glad to help you go and give me a good policy number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Policy number. You need policy number, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, it's W for Whiskey, 289-729-731.
[AGENT][NEUTRAL] All right, [PII], that is not one of APO's policy numbers. Ours is going to be an eight-digit certificate number. Do you see that anywhere, sir?
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Yeah, just wait. I will, I'm providing you the same.
[CUSTOMER][NEUTRAL] Give me a second.
[AGENT][POSITIVE] Yes, sir. Take your time.
[CUSTOMER][NEUTRAL] Yeah, it's 02551634.
[AGENT][POSITIVE] All right, [PII], that sounds like it. Thank you so much. Now, while I'm pulling this up, [PII], go ahead and give me a good return telephone call number, please, sir.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][POSITIVE] Alrighty, [PII], thank you.
[CUSTOMER][NEUTRAL] Should I repeat it?
[AGENT][NEUTRAL] Sir,
[AGENT][POSITIVE] No, I got it. Thank you very much.
[CUSTOMER][NEUTRAL] Yeah, uh.
[AGENT][NEUTRAL] All right, [PII], what's your patient's name and date of birth today, please, sir?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, it's [PII], [PII].
[AGENT][NEUTRAL] All right, [PII], thank you for that. Looks like she is a dependent on this medical supplemental plan, and you did say you want to check status of a claim. Is that correct?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Yeah, yeah. Correct.
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] Yeah, it's uh [PII].
[AGENT][NEUTRAL] Total bill?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] What's your total bill?
[CUSTOMER][NEUTRAL] Yeah, it's uh
[CUSTOMER][NEUTRAL] Uh, wait, yeah, it's 456. 21 cents.
[AGENT][NEUTRAL] All right, [PII], give me just a moment. Let's see what I can find.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, 219.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] All right, [PII], let's see. Looks like we do have that bill in-house for an office visit and lab. Looks like it has been processed.
[AGENT][NEUTRAL] Uh, let's see, you're gonna be getting a check for $4.61.
[AGENT][NEGATIVE] Office visit is not covered here. You're gonna be getting a check for $4.61. The office visit is not a covered benefit here.
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And why it is not covered?
[AGENT][NEUTRAL] Office visits are not covered here under this supplemental plan.
[CUSTOMER][NEUTRAL] OK. Uh, can you provide me the claim number?
[AGENT][NEUTRAL] Yes, claim number is 358.
[AGENT][NEUTRAL] 276 9.
[AGENT][NEUTRAL] You want me to give you your check check date as well?
[CUSTOMER][NEUTRAL] What is the check date?
[AGENT][NEUTRAL] The check is dated [PII].
[AGENT][NEUTRAL] Your check number?
[AGENT][NEUTRAL] It's 203-628-5.
[CUSTOMER][NEUTRAL] 2036285, right?
[AGENT][POSITIVE] That is correct, [PII], yes.
[CUSTOMER][NEUTRAL] And what is the check clear date?
[AGENT][NEUTRAL] Uh, let's see. Looks like your check is not, is not cleared the bank yet. It's not being cashed.
[CUSTOMER][NEUTRAL] OK, check, uh, can you provide me the check images?
[AGENT][NEUTRAL] I'm sorry, what was your question, [PII]?
[CUSTOMER][NEUTRAL] Yeah, should you provide me, uh, check images?
[AGENT][NEUTRAL] Check images. Uh, no, sir, we can't, but if, if you cannot locate this check in your office, do a little research, but if you can't locate it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Uh, give me a call back and we'll place a stop payment reissue on it, OK?
[CUSTOMER][NEUTRAL] Yeah, can you provide me the, uh,
[CUSTOMER][NEUTRAL] Claim process date?
[AGENT][NEUTRAL] The claim process date, yeah, let me get over to that screen.
[AGENT][NEUTRAL] Claim process date is 3-31-2025.
[CUSTOMER][NEUTRAL] 321 2025. And what is uh received date?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 326, 2025.
[AGENT][NEUTRAL] You want me to fax you over an EOB maybe, [PII]?
[CUSTOMER][NEUTRAL] 32
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Maybe, do you want me to fax you over an EOB? Would that help?
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah. Well, can you uh fax it to me?
[AGENT][NEUTRAL] I sure will.
[AGENT][NEUTRAL] I sure can, [PII]. Give me a good fax number.
[CUSTOMER][NEUTRAL] Yeah, it's uh
[CUSTOMER][NEUTRAL] Give me a second.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm gonna repeat that fax number back, [PII], and make sure I'm keying this in correctly. Area code [PII]. Was that the correct fax number?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, give me about 5 minutes and I'll get that over to you, [PII]. Is that all I can help you with?
[CUSTOMER][NEUTRAL] There
[CUSTOMER][NEGATIVE] Yeah, and uh you would not uh fax the checked images.
[AGENT][NEUTRAL] No, well, the EOB will have it on it, yes.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But according to.
[AGENT][NEUTRAL] Uh, [PII], is that all I can help answer for you today?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Is that all that I can help you with today?
[CUSTOMER][NEUTRAL] Yeah, and uh, in what time I will get the UV.
[AGENT][NEUTRAL] About 5 minutes.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 5 minutes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh what is your good name?
[AGENT][NEUTRAL] What is my name?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It's [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII] yes.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. And uh I, what is the claim, uh sorry, the call reference number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] We don't give call reference number, [PII], but you can use my name in today's date, OK?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] OK, thanks, [PII]. Thanks for the information.
[AGENT][POSITIVE] Yes, sir. Yes, sir, and thank you for calling APO [PII]. Have a great day.
[CUSTOMER][NEUTRAL] OK.