AccountId: 011433970860
ContactId: 8a7ee3a1-fc34-49e4-8860-fdcbd90154ae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 378839 ms
Total Talk Time (AGENT): 138413 ms
Total Talk Time (CUSTOMER): 179669 ms
Interruptions: 3
Overall Sentiment: AGENT=1.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/8a7ee3a1-fc34-49e4-8860-fdcbd90154ae_20250620T13:28_UTC.wav
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[AGENT][POSITIVE] Thank you for APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office and I'm looking for a claim for medical.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, [PII]. Happy to check on a claim. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] It's 02537820.
[AGENT][NEUTRAL] Thank you. And for documentation, do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. What is the patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is uh.
[CUSTOMER][NEUTRAL] [PII] date of birth of [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] My name is
[CUSTOMER][NEUTRAL] [PII] with the charge amount of $171 even.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So it looks like this claim was received on [PII].
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Claim was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] There was a benefit payment sent in the amount of $75.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] 75 even no member responsibility.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We're not able to advise on patient responsibility. That's up to the facility or provider.
[CUSTOMER][NEUTRAL] Uh, I mean to say like co-pay, coinsurance, or a deductible.
[AGENT][NEUTRAL] No, the patient has a limited benefit plan, so there is no co-pay or deductible. Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So allowed and paid the same for $75.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And uh can I have the check number or the EFT number for the payment?
[AGENT][NEUTRAL] The single check is 2031213.
[CUSTOMER][NEUTRAL] 2031213 single check check was also issued on [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Do you see a cash date by any chance if available?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] I do not have a cash date. I do show the check has been cashed.
[CUSTOMER][NEUTRAL] OK, no problem, and can you confirm the address on the check?
[AGENT][NEUTRAL] Yes, one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Check was sent to [PII].
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you for providing that information and what is the claim number?
[AGENT][NEUTRAL] That's gonna be 3571373.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] 3571373 is the claim number and uh I just have one more data service with the same member. Can I proceed to the next one?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, what's the data service?
[CUSTOMER][NEUTRAL] Then the second date of service is [PII].
[CUSTOMER][NEUTRAL] Charge amount of $114 114 dollars even.
[CUSTOMER][NEUTRAL] Same provider.
[CUSTOMER][NEUTRAL] Q as in Queen
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] By all.
[AGENT][NEUTRAL] Claim was received [PII]. Claim was processed on [PII]. There was a benefit payment sent in the amount of $75.
[CUSTOMER][NEUTRAL] 122.
[CUSTOMER][NEUTRAL] right
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] No patient responsibility and uh.
[CUSTOMER][NEUTRAL] Allowed and paid the same for $75 and the check number on this?
[AGENT][NEUTRAL] That is
[AGENT][NEUTRAL] It's going to be 2031214.
[CUSTOMER][NEUTRAL] 2031214 single check as uh.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] I'm on feed.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Check was also issued on [PII] paid to the same address.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And what is the claim number?
[AGENT][NEUTRAL] 3571375.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 3571375 can you send this EOB to my fax number that will help me?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's the fax?
[CUSTOMER][POSITIVE] Thank you. It's uh 561303.
[CUSTOMER][NEUTRAL] 2133. I'll confirm that. [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] 561303 [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Give it about 5 minutes to receive. Is there anything else I can check on for you?
[CUSTOMER][NEUTRAL] Can I have, uh, you send the both EOBs for this member or just one?
[AGENT][NEUTRAL] I can send both.
[CUSTOMER][NEUTRAL] Thank you. Please attach the first DOB we gone through and uh I just need your name spelling.
[AGENT][NEUTRAL] My name is.
[CUSTOMER][NEUTRAL] Last name initial, that's it.
[AGENT][NEUTRAL] My name is [PII], which is [PII] Initials my last name is [PII].
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Can I have a reference number for a conversation?
[AGENT][NEUTRAL] Call references my name with today's date.
[CUSTOMER][POSITIVE] Thank you sir have a great weekend.
[AGENT][POSITIVE] You're welcome. You too. Bye-bye.