AccountId: 011433970860
ContactId: a9a2be30-f665-4e2b-8566-b7446642d370
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 706190 ms
Total Talk Time (AGENT): 190487 ms
Total Talk Time (CUSTOMER): 135670 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/a9a2be30-f665-4e2b-8566-b7446642d370_20250325T14:09_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, stressing. My name is [PII]. Last insurance is W calling from provider's office checking on claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] 02 claims for 1 member.
[AGENT][NEUTRAL] OK. Yes, I can help you with that. And what is your um patient's policy number?
[CUSTOMER][NEUTRAL] Patient's policy number is
[CUSTOMER][NEUTRAL] 02252370
[AGENT][NEUTRAL] 52,370. OK, thank you one moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is, um, first off, any information that I do provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the first date of service for him, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $20,539.95.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said it's $20,530.95. Is that correct?
[CUSTOMER][NEUTRAL] It's $20,539.95.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] This claim was received.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The received date on this claim was [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 3511079.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $2940.68.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Check number.
[AGENT][NEUTRAL] And that was paid on single check, 2004968.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is it cash?
[AGENT][NEUTRAL] It is still showing as open.
[CUSTOMER][NEUTRAL] Uh, may I know the, can you please validate the address, please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah. Actually, uh, it is the correct address, but uh I don't know why it is still not cashed yet. So, can you please, uh, cancel the check and reissue the same address?
[AGENT][NEUTRAL] I will send a request to have that there.
[AGENT][NEGATIVE] and to request to void and reissue.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Because, uh, we, we are, because we are unable to find the check trace, uh, check traer as well.
[CUSTOMER][NEUTRAL] So that is why I'm requesting to please cancel it and uh the request to the concerned department to issue the check.
[AGENT][NEUTRAL] And as I stated, I would do that.
[CUSTOMER][POSITIVE] Yeah, thank you.
[CUSTOMER][NEUTRAL] And for the same date of service, there is one more time.
[AGENT][NEUTRAL] Same data service?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] $3420 even.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] This was also received on 925-2020.
[AGENT][NEUTRAL] 24 processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Claim number is 3511088.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The benefit
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 8877.82.
[AGENT][NEUTRAL] On single check 2004969.
[CUSTOMER][NEUTRAL] OK. 4969 and claim number is 3511088.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Thank you. Actually, uh, uh, is it cash?
[AGENT][NEUTRAL] Now, this one is still open to the mailing address on this one, on the claim form received is [PII].
[CUSTOMER][NEUTRAL] OK, not previous address.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. Just a moment, please.
[CUSTOMER][NEUTRAL] Uh, it is [PII], right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, just a moment, please.
[CUSTOMER][NEUTRAL] I'm just checking with my supervisor whether it is correct or not, please.
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And the address that we sent it to is the address that's on the claim form.
[CUSTOMER][NEUTRAL] OK, yeah. Yup. Then please uh cancel the check and reissue the and uh check to the same, same address.
[AGENT][NEUTRAL] OK, yes, sir. Well, um, that request also.
[CUSTOMER][NEUTRAL] Yeah, thank you. And uh may I know the card reference number please?
[AGENT][NEUTRAL] Uh yes, it would be my name, T R A C I [PII] my last name, [PII], along with today's date.
[AGENT][NEUTRAL] And if you need a copy of either of these, yes, explanation of benefits, you may print them, [PII], by going to our portal at [PII].
[CUSTOMER][POSITIVE] OK, ma'am. Thank you so much.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] You're welcome. And is there, yes sir, that's, that's all I can help you with for the moment.
[CUSTOMER][NEUTRAL] That's all for now.
[CUSTOMER][POSITIVE] Yeah, thank you.
[AGENT][POSITIVE] OK, well you're very welcome then and thank you again for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you. Bye-bye. You too.
[AGENT][POSITIVE] Uh, you're welcome. Bye bye.