AccountId: 011433970860
ContactId: 9017b041-42eb-483b-914c-7531405cd3f4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 524520 ms
Total Talk Time (AGENT): 174963 ms
Total Talk Time (CUSTOMER): 177806 ms
Interruptions: 3
Overall Sentiment: AGENT=2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/9017b041-42eb-483b-914c-7531405cd3f4_20250227T19:21_UTC.wav
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[AGENT][POSITIVE] Good. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] calling for a facility to check on a claim status.
[AGENT][NEUTRAL] I'm sorry, what was your name again?
[CUSTOMER][NEUTRAL] Yeah my name is [PII].
[AGENT][NEUTRAL] [PII], OK, and my name is [PII].
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] OK. And [PII], you have one claim that you're needing to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yeah, I have only one client.
[AGENT][POSITIVE] Yes, ma'am. I can help you. And what is your callback number, please?
[CUSTOMER][NEUTRAL] Yeah, the callback number is.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, [PII]?
[CUSTOMER][NEUTRAL] Yeah, the member's policy number is 02449038.
[AGENT][POSITIVE] Thank you. One moment, please.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is [PII]. And the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Yeah, the data services.
[CUSTOMER][NEUTRAL] [PII] with the bill amount of $670 even.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so this claim was received. The received date was [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 3556671.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That there was a benefit paid in the amount of $25.
[CUSTOMER][NEUTRAL] OK. Uh, could you please, yeah, go ahead.
[AGENT][NEUTRAL] And that was paid on single.
[AGENT][NEUTRAL] Single check, 2024762.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. You have a low amount of $25 right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That is the benefit that was paid on this claim and it states the remark on the here states with this payment, the maximum benefit amount.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] For services provided during this office visit is exhausted on a supplemental plan. Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And if you need a copy of this explanation of benefits, [PII], you may print that now that you have the claim number from our portal.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] By going to secure.
[CUSTOMER][NEUTRAL] No, no, yeah, I need a copy of you.
[AGENT][POSITIVE] Yes, I'm telling you how to get that. You can go to our portal and print it.
[AGENT][POSITIVE] And our portal website is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, OK, uh, uh, the amount is $25 and paid amount is $25 and there is, uh.
[CUSTOMER][NEUTRAL] No denials for the claim, right?
[AGENT][NEUTRAL] I read you the remark on the claim on the remark of the explanation of benefits. I read that to you. With this payment, the maximum benefit amount for services provided during this office visit is exhausted.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, just a moment.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah it'd be great
[CUSTOMER][NEUTRAL] for
[CUSTOMER][NEUTRAL] Uh, is the maximum benefits accepted, sir?
[CUSTOMER][NEUTRAL] About $1 or visits?
[AGENT][NEUTRAL] $25. That is the maximum.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Could you please provide me the pay date and the check issue date?
[AGENT][NEUTRAL] Uh, that is the date that the claim was processed, which was [PII].
[CUSTOMER][NEUTRAL] OK. Could you please provide me the
[CUSTOMER][NEUTRAL] Check your date.
[AGENT][POSITIVE] It is still outstanding at this time?
[CUSTOMER][NEUTRAL] OK, uh, OK. Could you please verify me the claim mail, uh, check mailing address, pay to address.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No you can you can go.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, uh, uh, could you please spell your name?
[AGENT][NEUTRAL] [PII] first initial to last name [PII], and you would use my name and today's date if you need a call reference number.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I'll.
[AGENT][POSITIVE] And can I help you with anything else today?
[CUSTOMER][POSITIVE] Nothing else, [PII]. Thank you for your help and have a nice day.
[AGENT][POSITIVE] OK. Well, you're welcome, [PII], and thank you again for calling APL and I hope you have a nice rest of your day as well.
[CUSTOMER][POSITIVE] Yeah, thank you, bye bye.
[AGENT][POSITIVE] Uh, you're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] I