AccountId: 011433970860
ContactId: e7158151-29ab-4ab5-9dd6-661137351859
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183860 ms
Total Talk Time (AGENT): 49144 ms
Total Talk Time (CUSTOMER): 97928 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/e7158151-29ab-4ab5-9dd6-661137351859_20250507T15:23_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APO. My name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII], and I'm calling with World Insurance, the broker's office, and I wanted to follow up on a member's claim to. I see that it's processed in the portal, so I just wanna see if it was paid out to the provider or the member.
[AGENT][POSITIVE] OK, I'll be happy to assist with the claim today um if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Uh, I have the policy number is 251-7410.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and the date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that and the date of service.
[CUSTOMER][NEUTRAL] Data of service, let me just open up the file.
[CUSTOMER][NEUTRAL] Date of service is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, we have more than one data service. What's the CPT code?
[CUSTOMER][NEUTRAL] I know it's for 8:54 and some change. It was like originally processed and you guys didn't have the full explanation of benefits, so I resubmitted it. I couldn't like connect it to the other claim, so I sent it separately, uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK, then.
[CUSTOMER][NEUTRAL] Yeah, the EOB had a few dates of service, but it was for, um, uh, the bill amount was 1,212 and the member responsibility was 854.25.
[AGENT][NEUTRAL] OK, so that went to the.
[AGENT][NEUTRAL] Patient.
[CUSTOMER][POSITIVE] OK, it was it it was paid out, it was, uh, completed.
[AGENT][NEUTRAL] Right. It went to the patient.
[AGENT][NEUTRAL] Because
[AGENT][NEUTRAL] The patient
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It came through as the patient, not the provider, was to receive payment.
[CUSTOMER][NEUTRAL] OK, yeah, that's fine, that's fine. I just wanna make sure I communicate it correctly to him, yeah, so it was accepted the EOB everything was processed fine.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] 00, OK.
[AGENT][NEUTRAL] Yeah, so that, that was the [PII], so the check will go out today.
[CUSTOMER][NEUTRAL] And it shows that it was.
[CUSTOMER][POSITIVE] OK perfect perfect I will let him know.
[AGENT][NEUTRAL] Alright, was there anything else I can assist with today?
[CUSTOMER][POSITIVE] No, have a wonderful day.
[AGENT][POSITIVE] Oh you too thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you. Alright, really quick that that check was for the 854 25, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK perfect thank you.
[AGENT][POSITIVE] All right. Thank you. Have a good day.
[CUSTOMER][NEUTRAL] OK, mm bye bye.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] You too bye.