AccountId: 011433970860
ContactId: b0c88a1c-60a6-453a-9e7f-978cd7faf1bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 343380 ms
Total Talk Time (AGENT): 122303 ms
Total Talk Time (CUSTOMER): 114706 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/b0c88a1c-60a6-453a-9e7f-978cd7faf1bf_20250305T21:16_UTC.wav
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[CUSTOMER][NEUTRAL] Your allergy pills.
[AGENT][NEUTRAL] Yeah, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] OK, give me one second. Hi, my name is [PII]. I'm calling from a provider's office. I was trying to check the status of a claim for one of your members.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] [PII], what is the policy number of that member that you're inquiring claim status for?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. The policy ID number is 02051968.
[AGENT][NEUTRAL] Thank you and what is this member's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] For [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] And [PII], what is the date of service that you're inquiring claim status for?
[CUSTOMER][NEUTRAL] Uh, it is for data service [PII].
[AGENT][NEUTRAL] Could you provide me with a procedure code?
[CUSTOMER][NEUTRAL] Um, I have 6 of them. Do you want all 6?
[AGENT][NEUTRAL] I just need one to verify the claim.
[CUSTOMER][NEUTRAL] OK, uh 0140.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] 7330
[AGENT][NEUTRAL] So this claim was received [PII]. It was processed [PII].
[CUSTOMER][NEUTRAL] Give me 1 2nd so I can write that.
[AGENT][NEUTRAL] There was a payment?
[CUSTOMER][NEUTRAL] Uh, you said it was, uh, received on [PII] and processed on [PII]. Was that correct?
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][POSITIVE] The [PII]. Sorry about that.
[AGENT][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Process on [PII] and you said there was a payment?
[AGENT][NEUTRAL] Of $680.
[CUSTOMER][NEUTRAL] OK, and it was that a check or OK check number.
[AGENT][NEUTRAL] Check number?
[AGENT][NEUTRAL] 2012436. It's 2012436.
[CUSTOMER][NEUTRAL] Thank you. And are you able to tell me if that check is cleared?
[CUSTOMER][NEUTRAL] Or been processed?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 201.
[AGENT][POSITIVE] Shows that it's outstanding.
[AGENT][NEUTRAL] It has not been cashed, but we will have to submit that to the finance department to actually verify if it has been cashed, but it was sent to the address of [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] Um, can we have that sent back to the finance department to determine if it has been cleared or not?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, just how many, uh, how long would it take to have an answer from your?
[AGENT][NEUTRAL] I'm not sure once I submit it to the finance department, I'm not sure how long it would take due to me working in the claims department. I could just make the request for them to verify if the check has been cleared or not and if it hasn't, then they'll get back with me to let me know that it has not been cleared and then adjuster will get a notification as well to reprocess the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We process and do they call, uh, will they call me back to let me know?
[AGENT][NEUTRAL] Well, if you would like for someone to give you a call back then they would.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, if I could request a call back just to make sure this stays on my radar and let me know if I need to do any additional follow up.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] What's your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I have [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Alrighty.
[AGENT][NEUTRAL] So I'm gonna send this over to the finance department for them to verify if the check has been cashed and if it hasn't been, they will give you a call back letting you know that the policy, the claim will be reprocessed. The check has been voided and the claim will be reprocessed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright
[CUSTOMER][POSITIVE] OK awesome thank you so much I appreciate it. Is there a call reference for today?
[AGENT][NEUTRAL] You're welcome. We don't provide those, [PII], however, you can use my name in today's date as a reference.
[CUSTOMER][NEUTRAL] OK, can you please provide me the spelling of your first name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you. I appreciate it. Have a good day.
[AGENT][POSITIVE] Thanks for calling APA. You have a great one as well. Goodbye.
[CUSTOMER][POSITIVE] OK thanks bye bye.