AccountId: 011433970860
ContactId: 97273388-9ce0-4cf2-bb56-719e5582e64e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 457299 ms
Total Talk Time (AGENT): 134579 ms
Total Talk Time (CUSTOMER): 120654 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/97273388-9ce0-4cf2-bb56-719e5582e64e_20250415T12:49_UTC.wav
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[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 provider's office for the claim status.
[AGENT][NEUTRAL] OK, spell your first name for me please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEGATIVE] OK, you cut out on me. I got.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I got [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], that's my name.
[AGENT][NEUTRAL] Oh, [PII], OK, thank you. OK, and you're calling for a claim status we can assist with that information. What's the policy number?
[CUSTOMER][NEUTRAL] L as in Lima. Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Policy number is 024.
[CUSTOMER][NEUTRAL] 87948, M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, give me one moment to pull up the file.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Viral Pa [PII].
[CUSTOMER][NEUTRAL] [PII] is the date of birth.
[AGENT][NEUTRAL] OK, thank you for that information and what's the date of service of the claim?
[CUSTOMER][NEUTRAL] They also
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the total charge?
[CUSTOMER][NEUTRAL] $1,919 even.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just for anesthesia?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I show the claim was received [PII] processed on [PII], issuing a payment of $85.50.
[CUSTOMER][NEUTRAL] OK, just
[CUSTOMER][POSITIVE] Oh, I'm sorry for interrupting you, ma'am. Could you please repeat once again so that I can make a note of it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, go ahead.
[AGENT][NEUTRAL] Hey, did you get the received date and the process date?
[CUSTOMER][NEGATIVE] No, no, I did not get that one.
[AGENT][NEUTRAL] [PII] is the date it was received.
[AGENT][NEUTRAL] [PII] is the date it processed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the check amount is for $85.56.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim number is 358.
[AGENT][NEUTRAL] 1962.
[AGENT][NEUTRAL] And did you have any other questions?
[CUSTOMER][NEUTRAL] You said the claim paid $84.66 right?
[AGENT][NEUTRAL] 85.56.
[CUSTOMER][NEUTRAL] OK,
[CUSTOMER][NEUTRAL] And is this paid to check and is it single or bulk amount?
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] It's an individual check, the check number?
[CUSTOMER][NEUTRAL] Single check or check.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 203.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 59.
[AGENT][NEUTRAL] 31
[CUSTOMER][NEUTRAL] Yeah, wait to address.
[AGENT][NEUTRAL] What is the address on this claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What is the address on the claim? Can you verify?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That's the address that's on the claim form?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Give me 1 2nd.
[AGENT][NEUTRAL] OK, I'm showing a different address.
[CUSTOMER][NEUTRAL] And may I know the
[CUSTOMER][NEUTRAL] Different address. Could you please verify with the address?
[AGENT][NEUTRAL] OK, I can confirm it if you can verify it if it's your claim, it should be on your itemized bill.
[CUSTOMER][NEUTRAL] OK, that is [PII].
[AGENT][NEUTRAL] Yeah, that's not the address that I'm showing that it went to.
[CUSTOMER][NEUTRAL] OK, so may I know the issue and cash date?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And are you calling on behalf of the provider's office or are you a third party vendor?
[CUSTOMER][NEUTRAL] No, no, I'm calling from provider's office.
[AGENT][NEUTRAL] OK. One moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] And I show the check is outstanding.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And when it has been issued?
[AGENT][NEUTRAL] The date that the claim was processed on the [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Will you please fax me the copy of COV?
[AGENT][NEUTRAL] It was actually mailed to the address that's on the claim form and it is now available to download online. Uh, our online address is secured. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Your call reference?
[AGENT][NEUTRAL] It's gonna be my name in today's date, [PII] and first initial of my last name is [PII].
[CUSTOMER][NEUTRAL] OK. May I know which address the claim has been paid?
[AGENT][NEUTRAL] OK, we can verify it, but if you don't have it on record, we have to get you to give it to us and we can verify it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] We already did with the both the address, servicing and provider address still not verified it.
[AGENT][NEUTRAL] Yeah, that's not the billing address on the claim form that was sent to us on the claim, I mean that's, that's not the billing address that you provided.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's all. Just one moment. We'll go to the next line. Let me check.
[AGENT][NEUTRAL] OK, and you can also check claim status online at [PII] and I can help you set that account up as well.
[CUSTOMER][NEUTRAL] All this.