AccountId: 011433970860
ContactId: b3e881dd-bb44-49c5-bc6e-ff75df3f76e2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285260 ms
Total Talk Time (AGENT): 130760 ms
Total Talk Time (CUSTOMER): 62129 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/b3e881dd-bb44-49c5-bc6e-ff75df3f76e2_20250529T14:14_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] Hey [PII], I'm calling for claim status.
[AGENT][NEUTRAL] OK, you're needing to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] OK, just a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have 02030165.
[AGENT][POSITIVE] OK, [PII], thank you. Give me a couple of moments please to get the member's information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] I have [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for him please?
[CUSTOMER][NEUTRAL] OK, that's 212 of 25.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the total is 14,377 and 30 cents, excuse me.
[AGENT][POSITIVE] Oh, thank you.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so I do show that this claim was received, [PII]. The received date was [PII]. It was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 357.
[AGENT][NEUTRAL] 0934.
[AGENT][NEUTRAL] And give me one moment to look at one thing.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Maybe. Hold on, I'm having trouble with one of my screens. I'm so sorry.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I do show that there was a benefit paid in the amount of $5000.
[AGENT][NEUTRAL] And that was paid on check number 2030781.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that check did clear on [PII].
[CUSTOMER][NEUTRAL] 3 1325.
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] And was there a patient responsibility?
[AGENT][NEUTRAL] This is a supplemental policy that helps with their co-pays, deductibles, and co-insurance amounts of covered services. So the remarks on here state that with the payment of this check, the maximum for this benefit has been met.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And part of the payable benefits were applied to the policy deductible of $100.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] And do you have a reference number?
[AGENT][NEUTRAL] Yes ma'am, you will actually use my name along with today's date and if you need a copy of this explanation of benefits, [PII], you can print that by going to our portal which is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright thank you so much, [PII].
[AGENT][POSITIVE] All right. Well, you are certainly very welcome. So is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, ma'am, that's it. Thank you so much.
[AGENT][POSITIVE] OK, well, you're welcome. And again, thank you for calling APL [PII]. Have a wonderful day.
[CUSTOMER][POSITIVE] Yes ma'am you too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.