AccountId: 011433970860
ContactId: e791a77a-b90d-4bc6-b7eb-afe0ae1af51c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 302309 ms
Total Talk Time (AGENT): 105369 ms
Total Talk Time (CUSTOMER): 94609 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/e791a77a-b90d-4bc6-b7eb-afe0ae1af51c_20250402T13:50_UTC.wav
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[AGENT][NEUTRAL] [PII], how can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII]. I am calling for the provider to check some dental clarification on the claim. Please note this call will be monitored for recording for quality and training purposes.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with claim status. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] So, [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Member ID is 02559074.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] [PII], charge amount is $248.04.
[AGENT][NEUTRAL] OK, one moment, I'm waiting on my system.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, is this for the Birmingham Internal Medicine?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. Yes, sir. We received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim paid out for $50 even.
[AGENT][NEUTRAL] The claim number is 3,572,470.
[AGENT][NEUTRAL] It was a single check for $50.
[AGENT][NEUTRAL] And the check number is 2,031,490.
[CUSTOMER][NEUTRAL] OK. Um, what about the balance CD code that 87804 modified QW?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Another safety code is 87804 modify it QW159.
[AGENT][NEUTRAL] OK. The remaining balance will be patient responsibility. Under this policy, we only cover up to $50 for um office visits.
[CUSTOMER][POSITIVE] Thank God.
[AGENT][POSITIVE] Mhm. No problem.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh, so this is the maximum amount, right? It was met.
[AGENT][NEUTRAL] Yes, sir. The maximum daily amount was met.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] And can I get the mailing address if you have?
[AGENT][NEUTRAL] Yes, our mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, may I know the time limit?
[AGENT][NEUTRAL] There's no timely filing limit?
[CUSTOMER][NEUTRAL] Got it. Um, attention to our opinion.
[AGENT][NEUTRAL] Um, attention to claims department.
[CUSTOMER][NEUTRAL] Claim department. Any form I need attached with the PIN?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No, sir.
[CUSTOMER][NEUTRAL] I got it.
[CUSTOMER][NEUTRAL] Um, actually, before the call reference number, uh, could you spell your name? Actually, I did not catch your name.
[AGENT][NEUTRAL] Yes, my name is [PII]. Um, it's spelled [PII] Last initial is [PII], and my name and today's date is the reference number.
[CUSTOMER][POSITIVE] I got it. Thanks for your help, Avi.
[AGENT][POSITIVE] Thank you, um, [PII] for calling APL. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] OK. Well, I thank you again for calling APL. You have a great rest of your day. Bye.
[CUSTOMER][NEUTRAL] Bye.