AccountId: 011433970860
ContactId: 9b3af700-acdf-4acd-aee5-9e5e3188c480
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 222270 ms
Total Talk Time (AGENT): 113234 ms
Total Talk Time (CUSTOMER): 93043 ms
Interruptions: 3
Overall Sentiment: AGENT=1.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/9b3af700-acdf-4acd-aee5-9e5e3188c480_20250107T19:29_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, my name is [PII]. I am, I am insured by you guys through Oxford. Um, I keep getting these checks. Um, I thought you guys reimbursed the, the.
[CUSTOMER][NEUTRAL] The doctor, but I've been getting receiving checks in the mail.
[CUSTOMER][NEUTRAL] And I'm not sure, am I supposed to then pay the, the call the doctor and pay the bill?
[AGENT][NEUTRAL] Well, it depends. Let me take a look, but it sounds.
[CUSTOMER][NEUTRAL] I've never had this happen before because I'm getting these checks and I'm not quite sure.
[AGENT][NEUTRAL] OK, I can look into it for you. So technically there's like a little box that has to be checked because if, if it's not checked, we can't legally give it to the doc. We have to send it to you because you, you know, submitted the claim, but I can look into everything for you.
[AGENT][NEUTRAL] Um, may I have a good contact number just in case we're disconnected and then your policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Policy number is 02555476.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And I have you here and [PII], I just need you to verify your last name, your date of birth, mailing and email address on file.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII], birthday [PII], address [PII].
[AGENT][POSITIVE] Thank you and then just your email.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So, is one of the payments for $45 and the other, oh, looks like they're both for $45.
[CUSTOMER][NEUTRAL] I want, yeah, but, and I got another check too just recently as well. I haven't even opened it up yet.
[AGENT][NEUTRAL] OK, let me know what.
[AGENT][NEUTRAL] So, there's 2 things. For these claims, no, that portion is yours because the provider was also paid on these claims.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Oh, OK, I don't unders I never got that before.
[AGENT][NEUTRAL] So, it look, let me see if the, hold on one second.
[CUSTOMER][NEUTRAL] I mean I did pay it, I think I paid a copay when I was there.
[AGENT][NEUTRAL] Was it a $40.45 dollars?
[CUSTOMER][NEGATIVE] For some of it, but some of it I didn't even pay a copay.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] The reason I'm asking because the
[AGENT][NEUTRAL] Hold on one moment. $30.30 dollars, same code.
[AGENT][NEUTRAL] It's like two lines here, we paid you and then we paid the provider $30 and we paid you $45.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] I, I don't know why I would pay because I didn't pay.
[AGENT][NEUTRAL] Let me reach out to claims, um, oh, you know what?
[AGENT][NEUTRAL] I'll do this. I'll go ahead and send a um a research request over to claims so that they can look into this for you and I'll give them your callback number for them to call. It's gonna be, I say 24 hours at the most to give you an update.
[CUSTOMER][NEUTRAL] OK, I was gonna say I'd be a con I've got a conference call. I gotta be on right now, so, OK, OK.
[AGENT][NEUTRAL] OK, so I'll do that and then they'll give you a call and let you know the breakdown.
[CUSTOMER][POSITIVE] OK, that's great. Thank you so much. Appreciate it.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help you with?
[CUSTOMER][POSITIVE] OK, thanks.
[CUSTOMER][NEUTRAL] No, that's it. I've gotta get on a call. OK, thank you. OK, thank you, bye-bye.
[AGENT][POSITIVE] Alright, alright, thanks for calling APU bye bye.