AccountId: 011433970860
ContactId: 865411b9-4d45-4ec6-a9ed-8cd0e847f5bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298529 ms
Total Talk Time (AGENT): 122903 ms
Total Talk Time (CUSTOMER): 89590 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/865411b9-4d45-4ec6-a9ed-8cd0e847f5bc_20250204T14:39_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, good morning. This is [PII] calling from provider office to check on the status of the claim.
[AGENT][POSITIVE] OK, I'm more than happy to assist you with the claim status. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you for that. And how many claims do you have in total today, [PII]?
[CUSTOMER][NEUTRAL] One.
[AGENT][NEUTRAL] All right. May I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure, just allow me one moment. I'll provide you that.
[AGENT][NEUTRAL] Sure. OK.
[CUSTOMER][NEUTRAL] Yeah, my policy number is.
[CUSTOMER][NEUTRAL] 01867119 M as in Mike L as in London number 8.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure, the number's first name is [PII] and the last name is [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And [PII], uh, may I have the date of service for the claim you'd like me to check on?
[CUSTOMER][NEUTRAL] Sure, just one moment. The date of services.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the total charge amount is $243 even.
[AGENT][NEUTRAL] Alright, and was that [PII], like [PII] or [PII]?
[CUSTOMER][NEUTRAL] It's 0830.
[AGENT][NEUTRAL] OK. Thank you and again just for the call, all the information provided is a verification of benefits, not a guarantee of payment. Hold on one moment while I locate that claim for you.
[AGENT][NEUTRAL] Can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] It is Atlantic of South Florida.
[AGENT][NEUTRAL] Alright, so I'm showing we received the claim on um [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 3511221.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on [PII], we paid out on the claim to the provider.
[AGENT][NEUTRAL] Um, $100.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was a single check. Did you need the check information?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So that is check number 200.
[AGENT][NEUTRAL] 4816.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, it was issued on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And I'm showing that it also cleared.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and did you need any other information from the check?
[CUSTOMER][NEUTRAL] Oh, just one moment and may I know the, OK, claim processed on [PII], right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEGATIVE] And there's no member responsibility.
[AGENT][NEUTRAL] So we don't determine patient responsibility, um, because we're not the major medical. For the outstanding balance, it would be just what your procedures are uh if there is an outstanding balance.
[CUSTOMER][NEUTRAL] Mm, OK, perfect. Yeah, all this information required, can it be possible for you to uh fax access the EOB?
[AGENT][NEUTRAL] Sure, what's a good fax number for you?
[CUSTOMER][NEUTRAL] Sure, just one moment.
[CUSTOMER][NEUTRAL] And the fax number is [PII].
[AGENT][NEUTRAL] And should I put attention, [PII]?
[CUSTOMER][NEUTRAL] I just.
[AGENT][NEUTRAL] And that's [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] All right, and I'll go ahead and fax this over to you now. And [PII], was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Uh, I just noted out your name your name, please.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I just moved out your name, your name, please.
[AGENT][NEUTRAL] My name is [PII], [PII].
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, good.
[AGENT][NEUTRAL] First initial to my last name is [PII].
[CUSTOMER][POSITIVE] Perfect. And only this information is required. Thank you so much. Have a great day.
[AGENT][POSITIVE] Thank you, you also, and thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Thank you.