AccountId: 011433970860
ContactId: 84edea48-588c-472d-bffe-28be5f47c832
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 415010 ms
Total Talk Time (AGENT): 148967 ms
Total Talk Time (CUSTOMER): 109817 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/84edea48-588c-472d-bffe-28be5f47c832_20250320T15:24_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, hi, my name is [PII] and the last name initial is [PII], calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, well, I'll be more than happy to help you with the claim status and the phone was going in and out. Did you say your name was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Uh well.
[CUSTOMER][NEUTRAL] 2,552,670.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the first name is [PII] and the last name is [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [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'd like me to check on?
[CUSTOMER][NEUTRAL] Yeah, and the date of service is on [PII].
[CUSTOMER][NEUTRAL] And this is for the amount of
[CUSTOMER][NEUTRAL] $1,471 sir.
[AGENT][NEUTRAL] $1,487?
[CUSTOMER][NEUTRAL] No, no. 1471, even.
[AGENT][NEUTRAL] OK, and it's [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] MBB radiology.
[AGENT][NEUTRAL] Alright, so I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 354.
[AGENT][NEUTRAL] 9214.
[AGENT][NEUTRAL] And on [PII], we paid out on the claim, a total of $169.94.
[CUSTOMER][NEGATIVE] And there's no patient responsibility, right?
[AGENT][NEUTRAL] Um, so we don't determine patient responsibility because we're not a major medical insurance company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the insurance paid $169.94 right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. And it, it was paid on [PII], correct?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. And may I have the uh payment details like is it through check or EFT?
[AGENT][NEUTRAL] Sure, let me get that for you. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it was a single check?
[AGENT][NEUTRAL] Check number 2021917.
[AGENT][NEUTRAL] It was issued on [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] January.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, could you please repeat the issue date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it was sent to [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And it is still listed um as outstanding. So if you like, I can send this over to have us check on the check and reissue it if you need to.
[CUSTOMER][NEUTRAL] Uh, your voice is breaking. Could you please fix your mom?
[AGENT][NEUTRAL] Can you hear me now?
[CUSTOMER][POSITIVE] Yes, I can.
[AGENT][NEUTRAL] OK, sorry about that. Um, I was saying.
[AGENT][NEUTRAL] It was issued in January, so it's been over 30 days, so I can have this, um, I can send over a request to have the check checked on, and if we need to reissue it, we can, or if it has been cleared, we can provide a copy of the cleared check.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right, so I'll go ahead and submit that for you. Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Uh, nothing else. I'm done.
[CUSTOMER][NEUTRAL] So the check number is 2021917, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And could you please fax your bill?
[AGENT][NEUTRAL] Sure, what's a good fax number for you?
[CUSTOMER][NEUTRAL] And our fax number is going to be [PII].
[AGENT][NEUTRAL] And should I put attention, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][POSITIVE] Uh, yes, that is correct.
[AGENT][POSITIVE] Alright, I'll go ahead and send this over for you now, [PII]. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] Uh, nothing else. Uh, no, thank you so much for assisting me. I'm done and you have a great day. Thank you. And may I have the call reference number?
[AGENT][NEUTRAL] Thank you, [PII]. Also thanks for calling. So there's no call reference number, but you can use my name and today's date. First initial to my last name is [PII].
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][POSITIVE] Mhm, that's correct.
[CUSTOMER][POSITIVE] All right, [PII], thank you for that. Yeah, thank you. Bye.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.