AccountId: 011433970860
ContactId: bb5dd8cf-1196-48f9-9fab-f13223855b64
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 360570 ms
Total Talk Time (AGENT): 114302 ms
Total Talk Time (CUSTOMER): 111899 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/bb5dd8cf-1196-48f9-9fab-f13223855b64_20250114T16:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from provider office to check the claim status, ma'am.
[AGENT][NEUTRAL] OK, I can help you spell your first name for me.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, [PII], thank you. And you said you're checking for benefits or claim status?
[CUSTOMER][NEUTRAL] Uh, it's for claim status, ma'am.
[AGENT][NEUTRAL] OK, and what's the policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. The ID number is D as in Delta 473.
[CUSTOMER][NEUTRAL] 052
[CUSTOMER][NEUTRAL] 99.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] The callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII] with date of birth, [PII].
[AGENT][NEUTRAL] OK, spell the patient's first and last name for me.
[CUSTOMER][NEUTRAL] Yeah, sure, ma'am. There's uh [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the last name is [PII].
[AGENT][NEUTRAL] OK, the, the first name is [PII]
[CUSTOMER][NEUTRAL] Yes, ma'am, right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the last name is [PII].
[CUSTOMER][POSITIVE] Yes, ma'am, it's right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And you are a medical or dental provider?
[CUSTOMER][NEUTRAL] It's for medical, ma'am.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Alright, thanks for verifying that information and we're checking a claim status.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And the date of service and total charge?
[CUSTOMER][NEUTRAL] The date of service is [PII] with the bill amount of $692 even.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Right, so I show the claim was received [PII].
[AGENT][NEUTRAL] Processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] There was no payment made on this particular claim. It's the outpatient treatment benefit provides an indemnity amount when a covered person receives treatment in an emergency room, urgent care facility, a physician's office.
[AGENT][NEUTRAL] Physical speech, occupational therapy, treatment in an outpatient hospital is not covered by this policy. Um, there was no payment made for that reason.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, ma'am.
[AGENT][NEUTRAL] And you want, do you need the policy number? I mean, the claim number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh yes, ma'am. Can I have that claim number?
[AGENT][NEUTRAL] Uh, that number is 354-1676.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, ma'am. Actually, uh, is there any patient responsibility, ma'am?
[AGENT][NEUTRAL] So it's not covered by the patient's policy. We do not determine patient's responsibility.
[CUSTOMER][POSITIVE] OK, ma'am. Thank you.
[AGENT][NEUTRAL] All right. Any other questions I can help out with today, [PII]?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Uh, could you please, uh, access the EOB, ma'am? Actually, we don't have the access to download the EOB, ma'am.
[AGENT][NEUTRAL] OK, it was actually mailed uh when the claim was processed.
[CUSTOMER][NEUTRAL] 189
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You don't have access to download it from the online service center?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK, and your fax number?
[CUSTOMER][NEUTRAL] The fax number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yes, ma'am. It's uh it is [PII], ma'am.
[AGENT][NEUTRAL] Mhm, I, I understood. Give me one moment.
[CUSTOMER][NEUTRAL] OK, ma'am.
[AGENT][POSITIVE] All right, any other questions I can help out with today, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, ma'am. Uh, may I have the call reference number, ma'am?
[AGENT][NEUTRAL] You'll use my name in today's state as your reference. [PII], first initial of my last name is [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK, thank you. Thank you so much for your assistance, ma'am.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You're welcome thank you for calling APL. Have a good day, [PII].
[CUSTOMER][POSITIVE] Have a nice day. Bye. Take care.
[AGENT][NEUTRAL] Bye bye.