AccountId: 011433970860
ContactId: c49ec0cd-a690-4e27-b97f-dffe0116bb32
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290230 ms
Total Talk Time (AGENT): 134514 ms
Total Talk Time (CUSTOMER): 91847 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/c49ec0cd-a690-4e27-b97f-dffe0116bb32_20250507T19:55_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII] [PII] at Methodist Healthcare calling for claim status please.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Mhm. Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And [PII], what is your callback number?
[CUSTOMER][POSITIVE] It's [PII]. That's correct.
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] Just one.
[AGENT][NEUTRAL] OK. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] The policy number is 02585069.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Enjoy any any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK, [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total field amount?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 226 25, 6979.50.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so this claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 3577.
[AGENT][NEUTRAL] 74.
[CUSTOMER][NEUTRAL] Uh, hold on one second, hold on. Oh shit, hold on, hold on one second. What where did my stuff go? Hold on, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Claim number 35.
[AGENT][NEUTRAL] I understand.
[AGENT][NEUTRAL] All right. OK, so the claim number again, I'm gonna start from the beginning, is 357-774-4.
[CUSTOMER][POSITIVE] OK, I'm ready.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] Alright, give me one second
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I do show that there was a benefit paid in the amount of $50.
[AGENT][NEUTRAL] And that was on single check.
[CUSTOMER][NEUTRAL] OK. What
[AGENT][NEUTRAL] 203.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 4620.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And the remark.
[CUSTOMER][NEUTRAL] Does the patient have?
[AGENT][NEUTRAL] On this claim, [PII] states with this check, the maximum benefit payable for this state of service has been met.
[CUSTOMER][NEUTRAL] Uh-huh, uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Max benefits, Mac benefits.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] How's the that.
[CUSTOMER][NEGATIVE] Be mad.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, now does the patient have any responsibility?
[AGENT][NEUTRAL] We do not determine patient responsibility, [PII], um, that would be up to the provider.
[CUSTOMER][NEUTRAL] OK, I sent it on OK.
[AGENT][NEUTRAL] And then if you need a copy of this explanation of benefits or for future reference we do have a portal choice that you should be able to check claim status for us in and then and that website for the portal is located at [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do not.
[CUSTOMER][NEUTRAL] Alright, do I have a call reference number?
[AGENT][NEUTRAL] Yes, ma'am, you would use my name along with today's date.
[CUSTOMER][POSITIVE] Thank you very much. Have a great evening, [PII].
[AGENT][POSITIVE] Well, I hope you have a great evening too, and thank you so much, um.
[AGENT][POSITIVE] For calling APL if that's all I can help you with, and I hope you have a nice evening, [PII].
[CUSTOMER][NEUTRAL] That's it.
[CUSTOMER][POSITIVE] Thank you, you too. I appreciate it. All right. Uh huh bye bye.
[AGENT][POSITIVE] Thank you. Mm bye-bye.