AccountId: 011433970860
ContactId: 97254add-89a6-4f21-bac9-20e6c151d114
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 264940 ms
Total Talk Time (AGENT): 91391 ms
Total Talk Time (CUSTOMER): 110238 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/97254add-89a6-4f21-bac9-20e6c151d114_20250421T20:15_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling from a provider's office and I just wanted to verify something on a claim for a patient, please.
[AGENT][NEUTRAL] Yeah, of course, I can help you with that claim. Do you have the policy number on you?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I do. Mhm. 02582808.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, [PII], what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright. And then the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] This is [PII] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then do you have the claim number by chance?
[CUSTOMER][NEUTRAL] I do, um, let me look at it. It is 35817997.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like the received date is [PII], what was your question? Sorry.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, I'm
[CUSTOMER][NEUTRAL] Oh, I was gonna say no, you're fine. I should say in the beginning. I'm looking at the explanation of benefits and I'm just trying to determine like is this an actual denial? I mean, does the patient even have coverage? I'm not, I'm kinda.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Not really sure.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Says we're waiting to confirm eligibility from benefits in a card.
[AGENT][NEUTRAL] Oh, so it looks like we paid $150 for this claim.
[CUSTOMER][NEUTRAL] Oh, OK, maybe I guess that happened after the fact.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] It very well could have, yes.
[CUSTOMER][NEUTRAL] That must have happened after.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, alright, so let me see here. Oh, you paid $150 on the claim that was only $126 so.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] Oh, I'm sorry. It's, it's calculating to, it looks like it was processed twice.
[AGENT][NEUTRAL] Sorry, yes, uh, we paid the $126.
[CUSTOMER][NEUTRAL] No, it's OK.
[CUSTOMER][NEUTRAL] Paid 126. OK. When did that take place, [PII]? Can you tell me that?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see, yes, let me look up the check number really quick.
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][NEUTRAL] It looks like [PII].
[CUSTOMER][NEUTRAL] OK, so just recently then, OK, 126, so it paid the full amount then, OK, um, do you have a check number just for my documentation that I can make a note of that?
[AGENT][NEUTRAL] Mhm. Yup.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, it's 203.
[AGENT][NEUTRAL] 8396.
[CUSTOMER][NEUTRAL] OK, was that a bulk check or just a single?
[AGENT][NEUTRAL] Yes, it's just a single check of 126.
[CUSTOMER][POSITIVE] Single, OK. OK, [PII], I appreciate your time and that information. May I have a reference number, please?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Of course. Yeah, it's [PII], my first name, [PII]
[AGENT][NEUTRAL] Last initial [PII] and then today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, well thank you for your help I appreciate it.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Of course. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Uh huh, no, that'll be all today [PII] you have a good rest of your day.
[AGENT][POSITIVE] All right. Yeah. Thank you. You too. Thanks for calling APL. All right, bye.
[CUSTOMER][NEUTRAL] Uh huh right uh huh bye bye.