AccountId: 011433970860
ContactId: 9ae9eb06-9ece-40fb-a5ed-085f4115d997
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 437109 ms
Total Talk Time (AGENT): 111801 ms
Total Talk Time (CUSTOMER): 229768 ms
Interruptions: 3
Overall Sentiment: AGENT=-0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/9ae9eb06-9ece-40fb-a5ed-085f4115d997_20250625T13:56_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider service. Check the claim status.
[AGENT][NEUTRAL] OK, I can verify claim status for you, [PII]. And what is the policy number, please?
[CUSTOMER][NEUTRAL] Which is 024.
[CUSTOMER][NEUTRAL] 49773. May I get your name again, sorry?
[AGENT][NEUTRAL] Sure, it's [PII] last initial [PII]
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And [PII], what is a good callback number in case the call drops?
[CUSTOMER][POSITIVE] Mhm thank you, ma'am.
[CUSTOMER][NEUTRAL] Which is [PII] direct line extension.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Thank you. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Um, first name is [PII]. Last name is [PII], and uh his date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Which is um [PII].
[CUSTOMER][NEUTRAL] And total charge amount I have which is $99 even.
[AGENT][NEUTRAL] OK. And do you have a balance after primary has processed the claim?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes ma'am, it is $23.30 2 3.30. Um, actually this is a follow-up call on [PII], the primary UB was faxed.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hold on.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what is the name of the provider's office?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's under um Community Medical Associate.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Oh I think I got it.
[CUSTOMER][NEUTRAL] Excuse me so long.
[AGENT][NEUTRAL] OK, I show that claim process says the insurance primary insurance paid in full. Therefore, no benefits are payable.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] May I know when you guys process the claim?
[AGENT][NEUTRAL] Sure, give me one moment.
[AGENT][NEUTRAL] Uh, I show this claim processed or received [PII] processed on [PII].
[CUSTOMER][NEUTRAL] OK, actually, the previous reps provide the same information with this, um, the claim is received on [PII], processed on [PII] due to no benefits payable by secondary since there is no any, uh, leftover amount like uh co-insurance, copay, deductible on the primary insurance.
[CUSTOMER][NEUTRAL] So that's what we faxed the primary insurance UP back on [PII]. So can you please double check that you receive the primary UP with the leftover amount?
[AGENT][NEGATIVE] No, cause on the EOB I'm showing that we received, there's no benefits applied towards deductible, copay, or co-insurance.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But that what uh uh we submit, we refax the correct to you to you guys on [PII] to the fax number which is [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] from the
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] 84.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi, my name is [PII].
[CUSTOMER][NEUTRAL] And uh the member ID number is.
[AGENT][NEUTRAL] OK, I do show it looks like it was reprocessed and a check was mailed in the amount of 2330. And this was on, give me a moment.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] Maybe it was.
[AGENT][NEUTRAL] This was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 23.30 was paid to provider, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, then do you have any check number?
[AGENT][NEUTRAL] I'm sorry, say again.
[CUSTOMER][NEUTRAL] What is the check number, ma'am? Do you have a check number?
[AGENT][NEUTRAL] 2045501.
[CUSTOMER][NEUTRAL] OK, and it was a bulk she was single.
[AGENT][NEUTRAL] Single.
[CUSTOMER][NEUTRAL] OK, may I know where it was issued?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Do you have any new plate number?
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] OK, uh, may I know when the payment was cashed or cleared?
[AGENT][NEGATIVE] It doesn't show that it's cleared.
[CUSTOMER][NEUTRAL] And the date of birth is [PII]. So you, you.
[CUSTOMER][NEUTRAL] You stated that cash. It's not cash Street, right?
[AGENT][NEGATIVE] It doesn't show in our system a cache date. It just showed it was issued on [PII].
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um, OK, almost one month is completed, so it is possible to initiate the check raiser for the cashed information.
[AGENT][NEUTRAL] We'll send a request to our finance so they can verify if the check is cleared or not.
[AGENT][NEUTRAL] If it has not cleared, then they can board and reissue since it's been over 30 days.
[CUSTOMER][NEUTRAL] OK. Can you please do it?
[CUSTOMER][NEUTRAL] OK, ma'am.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Mhm I'm ready for the caller license number.
[AGENT][NEUTRAL] You may use my name at today's date.
[CUSTOMER][POSITIVE] OK. Thank you. Have a great day. Bye.
[AGENT][NEUTRAL] You too. Bye.