AccountId: 011433970860
ContactId: e68184cd-8650-482f-8cc4-153971676ef2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275429 ms
Total Talk Time (AGENT): 131861 ms
Total Talk Time (CUSTOMER): 91130 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/e68184cd-8650-482f-8cc4-153971676ef2_20250306T20:05_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Um, yes, I was just calling to get claim status on a claim.
[AGENT][NEUTRAL] OK, I can verify claim status for you and your name is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Yeah it is.
[CUSTOMER][NEUTRAL] 02156231
[AGENT][POSITIVE] OK, thank you so much. One moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And let's see, and you're calling for claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what was that data service and amount of the charge?
[CUSTOMER][NEUTRAL] [PII] 254 380.
[AGENT][NEUTRAL] And do you have the balance after primary?
[CUSTOMER][NEUTRAL] $30.
[AGENT][NEUTRAL] 30. OK, thank you, ma'am. Give me one moment.
[AGENT][NEUTRAL] And while I'm looking up claim information, just to let you know we do have an online service center where providers can check claim status as well as print out the ELB. Uh, that site is at [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] You said [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. I did not know that.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am. And when you go to the site.
[CUSTOMER][NEUTRAL] Because I'd like to do everything online.
[AGENT][NEUTRAL] It seems like, well, a lot of places are headed that way, but um, you won't be able to verify benefits, but you can definitely verify claim status, and once you go to the site, you select in um new user and then I'm a medical dental provider and they'll ask for your tax ID and the patient account number, and from there you'll be able to set a username and password under that tax ID.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, I am and I'm on there now.
[CUSTOMER][NEUTRAL] Can I put
[CUSTOMER][NEUTRAL] I may
[CUSTOMER][NEUTRAL] Wait, where did it go? I'm an individual.
[AGENT][NEUTRAL] I think it's the last bullet point. I'm a medical.
[CUSTOMER][NEUTRAL] I'm a medical or dental. Oh, I just seen the dental. I was like, no, that's not me. OK.
[AGENT][NEUTRAL] Yes, I am.
[CUSTOMER][NEUTRAL] 08010 OK the patient account number that's gonna be there um.
[CUSTOMER][NEUTRAL] My account number?
[AGENT][NEUTRAL] No, ma'am. The patient account number um shown on this claim is that 350684.
[CUSTOMER][NEUTRAL] That I
[CUSTOMER][NEUTRAL] Oh OK, OK, yeah.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And um
[CUSTOMER][NEUTRAL] Oh.
[AGENT][POSITIVE] You're calling from again? I'm so sorry.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, uh, [PII].
[AGENT][NEUTRAL] OK. Well, I show the claim was processed and it paid $25 which is the benefit max for that office visit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this was on. Give me a moment.
[AGENT][NEUTRAL] Uh, it looks like it processed on the [PII], and so a check was mailed out on the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Is the patient responsible for that other $5?
[AGENT][NEUTRAL] Uh, we can't give patient responsibility. We can only verify how it's processed and, um, with that payment it ma their benefit for the date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, can I just get the call reference number?
[AGENT][NEUTRAL] Uh, we don't give reference numbers, but if you like, you may use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, perfect, and I just went on the website and signed myself up.
[AGENT][NEUTRAL] OK, and I can give you that claim number if you want to pull up that EOB.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 356-99887.
[CUSTOMER][POSITIVE] All right, thank you so much for your help.
[AGENT][POSITIVE] Oh, you're welcome. Thanks for calling APM Ms. [PII]. Have a great day.
[CUSTOMER][NEUTRAL] Alright you too bye bye.