AccountId: 011433970860
ContactId: e3194526-978d-4dce-874e-ddeebbb92f5b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 427920 ms
Total Talk Time (AGENT): 174061 ms
Total Talk Time (CUSTOMER): 99745 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/e3194526-978d-4dce-874e-ddeebbb92f5b_20250624T18:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Thank you. Good afternoon. My name is [PII] calling from provider office near the spine Institute and looking for claim status.
[AGENT][NEUTRAL] OK, I can check on a claim for you. Uh, you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh, can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Policy number is 02610272 M like Mike L like Lima 8.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Remember, first name is [PII]. First name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Um, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII], its bill amount is 20 $2,809.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what was the do you have the tax ID for this provider?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you for that one moment please.
[AGENT][NEUTRAL] [PII], do you happen to have the amount that was uh left over after major medical paid?
[CUSTOMER][NEUTRAL] Uh, after the primary page is $321.68 left.
[AGENT][NEUTRAL] 321 68.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Got it. OK, thank you for that one.
[CUSTOMER][NEUTRAL] 68.
[AGENT][POSITIVE] Thank you. OK, one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, I sure appreciate your patience. Thank you. It looks like we did receive a few claims for this state of service. Uh, I was able to locate this correct claim. Uh, we did pay a benefit of $127.07. Uh, whenever you're ready, uh, I can go ahead and give you that claim information and that check information.
[CUSTOMER][NEUTRAL] Yes, go ahead.
[AGENT][NEUTRAL] OK, that claim number is 36.
[AGENT][NEUTRAL] 07
[AGENT][NEUTRAL] 366.
[AGENT][NEUTRAL] And then this claim was received [PII].
[AGENT][NEUTRAL] And was processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then I've got that check number when you're ready.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That is 20.
[AGENT][NEUTRAL] 47
[AGENT][NEUTRAL] 306.
[AGENT][NEUTRAL] Uh, that check was issued [PII].
[AGENT][NEGATIVE] And I am showing it has not yet cleared.
[AGENT][NEUTRAL] If you have not received the check after 30 days of the issue date, uh, you can give us a call back and we will get it voided and reissued.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] If for once more time.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Oh, what is the last name? It's check not clear?
[AGENT][NEUTRAL] Uh, yes, it has not yet cleared. Um, if you have not received the check after 30 days of the issue date, which was [PII], then you can call us back and we will get this check voided and reissued.
[CUSTOMER][NEUTRAL] OK. What is, uh, it is a single, uh, payment of the bulk amount?
[AGENT][NEUTRAL] It's a single check, $127.07.
[CUSTOMER][NEUTRAL] Single check, uh.
[CUSTOMER][NEUTRAL] OK. And uh it's paid on.
[AGENT][NEUTRAL] It was issued on [PII].
[CUSTOMER][NEUTRAL] Is date is
[CUSTOMER][NEUTRAL] OK, $127 and uh all postal code is paid or partially process the claim?
[AGENT][NEUTRAL] Uh, let me go back and check that. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so we did not pay on procedure code 99204.
[AGENT][NEUTRAL] And that is because um office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEGATIVE] Offices are not covered.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] Under this policy.
[AGENT][NEUTRAL] Right. Under this policy, treatment received in office is covered, however, the visits are not.
[CUSTOMER][NEUTRAL] OK. Uh, thank you so much. And uh please, uh please uh send a copy of UB on our fax number.
[AGENT][POSITIVE] Absolutely, uh, what was that fax number for you?
[CUSTOMER][NEUTRAL] Uh, fax number is [PII].
[AGENT][NEUTRAL] OK, I'm going to read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][POSITIVE] Got it. OK, alright, I will go ahead and send that now. Uh, you should get it within about 10 minutes or so. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No problem. And what's, what's your name and call reference number?
[AGENT][NEUTRAL] So reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII]
[CUSTOMER][NEUTRAL] Got it. OK. And today's date?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, thank you so much and OK thank you and have a lovely day bye.
[AGENT][POSITIVE] Of course yeah thanks for giving us a call bye bye.