AccountId: 011433970860
ContactId: a268c3ba-fd66-44e4-8a1d-4659bd8316f9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 300130 ms
Total Talk Time (AGENT): 142048 ms
Total Talk Time (CUSTOMER): 103470 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/a268c3ba-fd66-44e4-8a1d-4659bd8316f9_20250203T16:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] from the provider's office. I have to check on a claim status. How are you doing today?
[AGENT][NEUTRAL] OK, um, I can check in a claim for you. I'm sorry, it's a little bit difficult to hear you. What did you say your name was?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] My name is [PII]. Yeah.
[AGENT][NEUTRAL] Got it um and then can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, uh, it is [PII].
[AGENT][NEUTRAL] OK, thank you and do you have the policy number?
[CUSTOMER][NEUTRAL] Uh, it is um 02544684.
[AGENT][NEUTRAL] Thank you. Uh, what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] It's uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] It is [PII]. The total bill amount is $528 even.
[AGENT][NEUTRAL] 528. OK, thank you one moment please.
[CUSTOMER][NEUTRAL] Yup.
[AGENT][NEUTRAL] What was the name of the provider's office this was with [PII]?
[CUSTOMER][NEUTRAL] Yeah, it is Community Medical Associates.
[AGENT][NEUTRAL] Do you have that tax ID by chance?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK thank you we've got it as a Norton maternal fetal medicine, um, so I did find this claim, OK, so we paid a benefit of $50.
[CUSTOMER][POSITIVE] Petal medicine, yes, that's right.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And that was the uh maximum?
[AGENT][NEUTRAL] So that did meet their calendar year maximum with that payment.
[CUSTOMER][NEUTRAL] Mm, OK. So when will the claim received?
[AGENT][NEUTRAL] 01 moment, let me get that.
[AGENT][NEUTRAL] This claim was received [PII].
[AGENT][NEUTRAL] And it was processed [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And uh do you have a claim number?
[AGENT][NEUTRAL] Yes, uh, let's see, that is 35.
[AGENT][NEUTRAL] 55
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 496.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 496 and the paid amount is $50. And may I know the mode of payment?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] It was a check. I do have that check number whenever you're ready.
[CUSTOMER][NEUTRAL] Yes, ma'am. The check numbers.
[AGENT][NEUTRAL] It is 20.
[AGENT][NEUTRAL] 242-83.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is it a bulk check or single check?
[AGENT][NEUTRAL] Single check of that $50.
[CUSTOMER][NEUTRAL] All right. And uh could you please verify the pay to address and uh the check, uh check issue date?
[AGENT][NEUTRAL] Of course
[AGENT][NEUTRAL] Yes, so this check was issued [PII], and that address was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Uh, is there any patients Yes, ma'am, that's right. Uh do you have any co-pay or patient responsibility?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, there we don't say what is patient responsibility, uh, that would be up to the provider.
[CUSTOMER][NEUTRAL] All right. And it is the maximum allowed amount for this uh service, right?
[AGENT][POSITIVE] Was $50 that's correct.
[CUSTOMER][NEUTRAL] All right. And uh,
[CUSTOMER][NEUTRAL] OK. So, uh, let me just uh repeat the plan.
[AGENT][NEUTRAL] If you'd like [PII], I can send you a copy of this EOB.
[CUSTOMER][POSITIVE] Yes, yes. That would be great. Yeah.
[AGENT][NEUTRAL] OK, do you have a fax number?
[CUSTOMER][NEUTRAL] Yeah, one minute. The fax number is 732.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 289
[CUSTOMER][NEUTRAL] 9254.
[AGENT][NEUTRAL] OK, I'm going to repeat that back, make sure I heard that correctly, that was [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] OK, I wanna just put this to your attention, [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I will go ahead and get that sent to you now. I should get that here in maybe 10-15 minutes depending on how busy your machine is. Uh, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] May I have the call reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII]
[CUSTOMER][NEUTRAL] OK. All right. [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Right. All right. You have a wonderful day. Thank you so much for your help. Take care. Bye-bye.
[AGENT][POSITIVE] Yeah, thanks for calling APO you too bye bye.
[CUSTOMER][NEUTRAL] Bye bye, bye bye.