AccountId: 011433970860
ContactId: dd823c46-9271-4bad-a6de-593a6b6650b4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 848780 ms
Total Talk Time (AGENT): 212452 ms
Total Talk Time (CUSTOMER): 167382 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/dd823c46-9271-4bad-a6de-593a6b6650b4_20250403T18:24_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office and looking on a claim status. Can you help me?
[AGENT][NEUTRAL] Sure, I can assist you with claim status, Ms. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, the callback number is [PII].
[CUSTOMER][NEUTRAL] Extension [PII].
[AGENT][NEUTRAL] Thank you. Um, and may I have uh the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, the patient's policy number is 02451768ML8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, the patient's name is [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] what the date of service and the amount of the claim.
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII] for $211 even.
[AGENT][NEUTRAL] It was [PII].
[CUSTOMER][NEUTRAL] Yeah, [PII]
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK. All right. Let me see if I can find that claim for you. Do you mind holding for me?
[CUSTOMER][NEUTRAL] Yes, sure. OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for Miss [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hello. OK, all right, so it looks like we processed this claim on [PII] and we send a benefit amount of $60 to the provider.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] One moment. So may I know the received date?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the receipt date of the claim, let's see one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, 8853. It was received on [PII], process on [PII].
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] And uh it was paid for $60 am I right?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] And may I know the payment details?
[AGENT][NEUTRAL] Yes, it was a single check paper check. Um, the check number is 2,034,180.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And it was issued on?
[AGENT][NEUTRAL] The same date of process on [PII].
[CUSTOMER][NEUTRAL] And it, it has been cashed?
[AGENT][NEUTRAL] Yeah, well, it's too soon to know. It was recently done.
[CUSTOMER][NEUTRAL] OK, I need to allow 30 days.
[AGENT][NEUTRAL] Um, yes.
[CUSTOMER][NEUTRAL] OK, may I know the pay to address?
[AGENT][NEUTRAL] All right, it was sent to, let's see.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Um, [PII].
[CUSTOMER][NEUTRAL] OK. And uh may I know the claim number?
[AGENT][NEUTRAL] The claim number is 357-8853.
[CUSTOMER][NEUTRAL] 357-885-3.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] And it's, you'll be also sent to the provider's office with the check.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. For the same, uh, patient, I have one more date of service.
[AGENT][NEUTRAL] OK, in your right hand.
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII] for $230 even.
[AGENT][NEUTRAL] OK, let me pull that you'll be on this [PII] moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So it looks like this one was
[AGENT][NEUTRAL] Process on [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we send a benefit amount of $50 on this one.
[CUSTOMER][NEUTRAL] If there is any patient $60?
[AGENT][NEUTRAL] Firstly, 50.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Is there any patient responsibility on this one?
[AGENT][NEUTRAL] Uh, let's see if there's anything remaining. OK, so if there's anything after the $50 the maximum benefit on this policy is $50.
[AGENT][NEUTRAL] So that's all I will pay for an office visit.
[CUSTOMER][NEUTRAL] OK. And uh may I know the received date on this one?
[AGENT][NEUTRAL] OK, this one was received, let's see.
[AGENT][NEUTRAL] OK, it was received on [PII].
[CUSTOMER][NEUTRAL] And paid for $50 and after 50, it's patient responsibility, am I right?
[AGENT][NEUTRAL] It's up to the provider's discretion, but you can go back to the.
[AGENT][NEUTRAL] Um, major medical physician. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And uh may I have the uh payment information for this one as well?
[AGENT][NEUTRAL] OK, yes. Mhm, one moment.
[AGENT][NEUTRAL] OK, so we have, um, it's a paper check, a single check.
[AGENT][NEUTRAL] And the claim number is 2032558.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 203-255-8.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It was issued on [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And no cash date.
[AGENT][NEUTRAL] No. And this one went to uh address [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII]. Am I right?
[AGENT][NEUTRAL] [PII], yes. Mhm.
[CUSTOMER][NEUTRAL] OK. And we need to allow 30 to 45 business days for the check to be cashtomatic.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] And the claim number?
[AGENT][NEUTRAL] That is 357-5063.
[CUSTOMER][NEUTRAL] 3575063.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For this one also, you we went to the provider's office to check me.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Can you spell your name for me?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And the call reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's day if you would like.
[CUSTOMER][POSITIVE] OK. Thank you so much for the information you provided me on this call.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day.
[CUSTOMER][POSITIVE] You too as well. Thank you so much. Bye-bye.
[AGENT][NEUTRAL] Mm.