AccountId: 011433970860
ContactId: de7af474-8eaf-415a-b25d-6584f3fe1e0c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1110959 ms
Total Talk Time (AGENT): 172415 ms
Total Talk Time (CUSTOMER): 69219 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=-2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/de7af474-8eaf-415a-b25d-6584f3fe1e0c_20250310T14:54_UTC.wav
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[AGENT][POSITIVE] Good Morning, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. Yes, I'm calling on a recorded line trying to get status on the phone.
[AGENT][NEUTRAL] Uh, sure, I can assist you with claim status. May I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And Ms. [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 226-303-2
[CUSTOMER][NEUTRAL] And I'm sorry, what was your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[AGENT][NEUTRAL] And Ms. [PII], may I have the name of the facility you're calling from? You're welcome.
[CUSTOMER][POSITIVE] Alright thank you.
[CUSTOMER][NEUTRAL] Wilkes-Barre Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, what's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] for 56, 89025.
[AGENT][NEUTRAL] All right, let me see if I can find this claim. And for future, you can check claim status online through our website at [PII] and that's just optional.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let's see, so that's gonna be the facility charges. Let me go ahead and pull this EOB one moment.
[AGENT][NEUTRAL] OK, I'm waiting on the EOB. It's gonna be a minute.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, OK, so it looks like we processed the claim on [PII] and we send a benefit amount of $4,304.04. It looks like with the payment of that check, the maximum has been exhausted.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For this member.
[AGENT][NEUTRAL] Do you need the
[CUSTOMER][NEUTRAL] So no payment was made is that billable?
[CUSTOMER][NEUTRAL] To the patient
[AGENT][NEUTRAL] Uh, we send a payment of $4,304.04.
[AGENT][NEUTRAL] And the reason for that payment is because that was the the amount remaining on the policy maximum.
[CUSTOMER][NEUTRAL] Oh, OK, um, we never received a check. Are you showing us cash?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I can check and see, bear with me.
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] Alright, let's see.
[AGENT][NEUTRAL] Um, it doesn't look like a cash, um, what is the address they're supposed to go to?
[CUSTOMER][NEUTRAL] Um, the PO box is [PII].
[AGENT][NEUTRAL] OK, so that is the address we send it to. Um, what I can do is go ahead and send a request for um to see if it did go through the bank. Um, it is not showing that it has in my system, but um we have a different system. So let me just go ahead and request and see if it's not um that you want me to go ahead and send the request for reissue.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so let me go ahead and send the request over. Do you mind holding for me?
[CUSTOMER][POSITIVE] No problem.
[AGENT][POSITIVE] OK, one moment, 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.
[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 me. OK, I went ahead and send the request for this check to be canceled and reissued, OK? So it will take 24 to 48 hours for them to work on that and then they will send it by mail.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect um.
[AGENT][NEUTRAL] OK. Is there anything else?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, I think that's it. Is there a reference number for the call? Oh no, I, I do need one other thing. What's that claim number?
[AGENT][NEUTRAL] We
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Oh sure. The claim number is 3541212.
[CUSTOMER][NEUTRAL] Hold on a second
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 3541212.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Alright, and then is there a reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][POSITIVE] Sounds good thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] That's it.
[AGENT][NEUTRAL] Mm.