AccountId: 011433970860
ContactId: 83c5a3c6-1623-4781-8b8f-66678bc9ceca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256920 ms
Total Talk Time (AGENT): 112122 ms
Total Talk Time (CUSTOMER): 100067 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/83c5a3c6-1623-4781-8b8f-66678bc9ceca_20250124T21:18_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, my name is [PII]. I'm calling from Metro MPC. I'm calling for claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII]. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] One
[AGENT][NEUTRAL] Alright, and may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Uh, uh, oh my God, my phone number is [PII]. Uh, patient's ID number is [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you want me to check on in the total bill?
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII]. Total bill charge is $821.
[AGENT][NEUTRAL] Thank you for that, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Uh, Metroderm PC.
[AGENT][NEUTRAL] OK, here we go. And I'm showing the claim was received on [PII].
[AGENT][NEUTRAL] That claim number is 353.
[AGENT][NEUTRAL] 4136.
[AGENT][NEUTRAL] And on [PII], we paid out on the claim a total of $175.
[AGENT][NEUTRAL] Did you need that checking information?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, hold on one moment, let me get it for you.
[AGENT][NEUTRAL] So I'm showing check number 20169998.
[AGENT][NEUTRAL] It's a single check.
[AGENT][NEUTRAL] Um, issued on [PII].
[AGENT][NEUTRAL] It was mailed to [PII].
[AGENT][POSITIVE] But I am still showing that it's outstanding. Um, so since it's, um, after 30 days, if you like, I can send a request to [PII] to have the check checked on and then if we need to reissue to you, we can.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, no, we'll wait a little longer. Mail has been extremely slow down, uh, around [PII], and we've had an issue where we've requested a stop payment and a reissue and then the original payment will show up like a month after that, um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we'll allow more time and see if it just does show up at any point and then if it doesn't, um, then we'll um come back and look at that option. Uh, if we don't do that or something happens, do you know what the time frame is for payment to be automatically issued? Is 60 days, 90 days, 120 days?
[AGENT][NEUTRAL] Wait a minute. You said do I know for the payment to be automatically issued, what do you mean?
[CUSTOMER][NEGATIVE] So like because it's a paper check, you know, with paper checks there's like a, a point where you can't cash it or do anything with it anymore. It's just void after automatically so it is 30 days.
[AGENT][NEUTRAL] 0, 30 days.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] It's normally like 60 or 90 days.
[AGENT][NEUTRAL] You're asking for the amount of time on the check to cash it.
[AGENT][NEUTRAL] For the amount of time.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] You know it's OK, don't worry about it. I'll, we'll figure it out, um, we will follow up if the payment does not show up in our office.
[AGENT][NEUTRAL] OK, well, was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No, thank you, ma'am. That was it. Um, just a reference number for the call.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. Um, so again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] And today's.
[CUSTOMER][POSITIVE] OK great thank you very much ma'am I appreciate your help.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a great weekend.
[CUSTOMER][POSITIVE] You as well thank you bye.
[AGENT][POSITIVE] Thank you. Bye-bye.