AccountId: 011433970860
ContactId: 9a535d55-dc9f-4ee5-96c2-3ff4626a3802
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284500 ms
Total Talk Time (AGENT): 149851 ms
Total Talk Time (CUSTOMER): 117878 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/9a535d55-dc9f-4ee5-96c2-3ff4626a3802_20250129T18:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, uh, [PII], I am just uh checking on uh status of a claim. If I could, I just have one.
[AGENT][NEUTRAL] Sure, yeah, I can check on a claim for you. uh, what was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII], is this for your individual policy or are you with the provider?
[CUSTOMER][NEUTRAL] With a provider.
[AGENT][NEUTRAL] OK, and [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure it is [PII].
[AGENT][NEUTRAL] All right, thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I hope that's what it is. It is 02556849.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Mhm sure.
[AGENT][NEUTRAL] Alright, and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that [PII]. OK, so that was the correct policy number. Um, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, do you have the bill amount?
[CUSTOMER][NEUTRAL] I have $583.
[AGENT][POSITIVE] Got it. OK, thank you. One moment please.
[CUSTOMER][NEUTRAL] Mhm sure.
[AGENT][NEUTRAL] Oh, I'm sorry, [PII], what was the name of the provider's office that you're with?
[CUSTOMER][NEUTRAL] OK, it is Southern Illinois Medical Services.
[AGENT][POSITIVE] Perfect. I do believe I've found this claim. So it looks like we paid a benefit of $75. If you give me one moment, I will get that information to you.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so the $75 did uh meet the maximum benefit payable for the date of service. Um, as for the other line items, it does state the policy does not provide benefits for uh vaccines and immunizations or the administration of the injections.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so, so then the $75 is that just for the office visit then?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, got you, got you, got you, but the rest of it is not covered by the policy. OK, OK, um, let me ask.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's correct. All right, did you need that claim number or check number?
[CUSTOMER][NEUTRAL] Both if you would please.
[AGENT][NEUTRAL] Of course, yes. So that claim number is 354-9240.
[CUSTOMER][NEUTRAL] OK and you said you had a check number, was it?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] So that check number is 2,021,890.
[CUSTOMER][NEUTRAL] OK, uh, are you able to tell me, [PII], uh, when that check was issued?
[AGENT][NEUTRAL] Yes, absolutely. So I am showing that check was issued [PII], and it has not yet cleared. So for our policy after 30 days, uh, from the issue date if it has not cleared, if y'all haven't received it, uh, you can give us a call we will have it voided and reissued.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Excellent wow, that's awesome. OK, OK, now could I do one more thing?
[AGENT][NEUTRAL] OK, did you need a copy of the Angie?
[CUSTOMER][NEUTRAL] Go ahead. I'm sorry, say that again, mhm.
[AGENT][NEUTRAL] Oh sorry, oh, I was just asking if you need a copy of the EOB.
[CUSTOMER][NEUTRAL] Would that be too much trouble to ask if it can, I mean, if it can be faxed, that'd be great. If not, no.
[AGENT][POSITIVE] I offered Angie, of course, it's not trouble.
[CUSTOMER][POSITIVE] OK great great great.
[AGENT][NEUTRAL] Of course, what's that fax number for you?
[CUSTOMER][NEUTRAL] OK it is [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and when I just put this to your attention?
[CUSTOMER][NEUTRAL] If you would please, yes, and if you would put my last initial [PII] as in hotel, there are two of us.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Got you OK and then I'm so sorry what were you going to ask me before?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Uh, well, actually what you just offered to do was, you know, about the EOB, so you're, you're ahead of me, which is great, mhm, mhm, yeah, yeah.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] CEOB
[AGENT][NEUTRAL] OK, alrighty, well, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Do you have a call reference number?
[AGENT][NEUTRAL] Yes, reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] A R A, last initial is A.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and today's date, wow, the [PII]. OK, alright.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] I know it.
[AGENT][POSITIVE] Alright, well thanks for calling APL. Yeah, thank you, you too. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] I appreciate your help and your time you've been pleasant and uh thank you.
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][POSITIVE] You too, thanks, [PII]. Bye bye.
[AGENT][NEUTRAL] Bye bye.