AccountId: 011433970860
ContactId: c716c656-100e-455a-8f91-5199a4576279
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 343309 ms
Total Talk Time (AGENT): 97409 ms
Total Talk Time (CUSTOMER): 100972 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/c716c656-100e-455a-8f91-5199a4576279_20250210T20:26_UTC.wav
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[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider service checking on a claim status.
[AGENT][NEUTRAL] OK, I can check that claim for you. Can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII], no extension direct line.
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 02450098M as in Mary, L as in Lima, and 8.
[AGENT][NEUTRAL] OK. Thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Member's name is [PII] [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that, [PII]. And what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Date of service is [PII] and total charges are $542 even.
[AGENT][NEUTRAL] I'm sorry, that was 1,242?
[CUSTOMER][NEUTRAL] $542 even 542.
[AGENT][NEUTRAL] 500. OK, got it, thank you one moment.
[AGENT][NEUTRAL] Was this for uh gastrohealth?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII], we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK, yeah, previously I have called for this, but we have requested a new will be through fax, but we haven't received the fax. I need the fax for this.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure I can send that to you. uh, what was that fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and this would just go to your attention?
[CUSTOMER][NEUTRAL] Attention to my name, [PII].
[AGENT][POSITIVE] OK. All right. I will get that sent to you right now. Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] I have one more claim.
[AGENT][NEUTRAL] OK, one moment please I'll let you know when I'm ready for that.
[CUSTOMER][NEGATIVE] Yeah, because we are unable to download EOB through portal also the portal is not working.
[AGENT][POSITIVE] Yeah, no worries I can get this sent to you. Give me just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what this other claim was this for a different um member or was this for the same number?
[CUSTOMER][NEUTRAL] Different member?
[AGENT][NEUTRAL] OK, I am ready for that next policy number.
[CUSTOMER][NEUTRAL] 02288208 M as in Mary, L as in Lima and 8.
[AGENT][NEUTRAL] I'm so sorry, [PII], could you repeat that policy number, please?
[CUSTOMER][NEUTRAL] Yeah. 02288208. M as in Mary, L as in Lima, and 8.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Got it thank you one moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for this number?
[CUSTOMER][NEUTRAL] Member's name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Date of service is [PII] and total charges of $348 even.
[AGENT][NEUTRAL] 48, OK.
[AGENT][NEUTRAL] OK, yes, we were unable to pay this benefit as well because it this policy also doesn't cover office visits, um, and you just needed this uh EOB faxed to the same number.
[CUSTOMER][NEUTRAL] Yeah, same number.
[AGENT][POSITIVE] OK, I will get that sent to you. Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, but I didn't get the.
[CUSTOMER][NEUTRAL] First claim facts you know.
[AGENT][NEUTRAL] I just sent it, um, it might take about 10-15 minutes for you to receive it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you. So you have faxed the second claim also, right?
[AGENT][NEUTRAL] I'm getting that sent right now. I did send that first one though.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] OK, and that second one just sent.
[AGENT][NEUTRAL] Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] Alright, well thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Yeah.