AccountId: 011433970860
ContactId: b260af35-459b-4b56-a559-dbcef29545f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 280600 ms
Total Talk Time (AGENT): 124632 ms
Total Talk Time (CUSTOMER): 75917 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/b260af35-459b-4b56-a559-dbcef29545f3_20250224T17:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes ma'am, I'm looking at a patient's ledger, um, and it looks like I have several claims that I have not gotten payment on on my end.
[AGENT][NEUTRAL] OK, I can check the claims with you. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, that is.
[CUSTOMER][NEUTRAL] 607-703
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII] and it's [PII].
[AGENT][NEUTRAL] Thank you for that and um you can provide the dates of service and the total bills if you like.
[CUSTOMER][NEUTRAL] On the date of service, the first one is all the way back from [PII], and that total.
[CUSTOMER][NEUTRAL] Is 245 + 65 is 490 and then I have 1216 of 24.
[CUSTOMER][NEUTRAL] And that one.
[CUSTOMER][NEUTRAL] Is 167.
[AGENT][NEUTRAL] OK. Were there any others or just those two?
[CUSTOMER][NEUTRAL] Um, just those two.
[AGENT][NEUTRAL] OK. And all the information provided is a verification of benefits, not a guarantee of payment. Hold on one moment.
[AGENT][NEUTRAL] While I search the claims, um.
[AGENT][NEUTRAL] And what is the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so for the [PII], um, data service, we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 349.
[AGENT][NEUTRAL] 897, I'm sorry, 3498967.
[AGENT][NEUTRAL] And on [PII], we paid out on the claim a total of $314.
[AGENT][NEUTRAL] To the provider. Let me get that information.
[AGENT][NEUTRAL] Um, so it was a single check, check number 187.
[AGENT][NEUTRAL] 0467.
[AGENT][NEUTRAL] It
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] It was issued on [PII] and it cleared on [PII].
[CUSTOMER][NEUTRAL] OK, can I have that EOB sent to me?
[AGENT][NEUTRAL] Mhm. What's a good fax number for you?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And would you need the both of the claims that we're going over the EOB sent?
[CUSTOMER][NEUTRAL] Um, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then um for the second one, was that all you needed for the first one? I didn't want to move on. OK. Um, so for the second one.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] We received that claim on [PII].
[AGENT][NEUTRAL] Claim number is 3567054.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], um, we paid out to the provider $128.
[CUSTOMER][NEUTRAL] OK, so we probably just haven't received that yet.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Did you still want me to send the 2nd 1? The 2nd 1 is probably on the way to you.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Um, no, just the first one if you can.
[AGENT][NEUTRAL] You sure? OK. So I'll go ahead and send this over to you now.
[AGENT][NEUTRAL] And then was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Um, nope, that's it.
[AGENT][POSITIVE] Alright well thank you so much for calling APL. I hope you have a great day, [PII].
[CUSTOMER][POSITIVE] Alright thank you you too.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Alright bye.