AccountId: 011433970860
ContactId: e86e906f-57ad-440b-9ebd-51493f93dfc7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 389000 ms
Total Talk Time (AGENT): 102349 ms
Total Talk Time (CUSTOMER): 90064 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/e86e906f-57ad-440b-9ebd-51493f93dfc7_20250324T21:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, um, I need claim status, please.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] OK, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Are you with the provider's office?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] D
[CUSTOMER][NEUTRAL] 43,510,340
[AGENT][NEUTRAL] OK, hold on just a second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] OK, sorry, my system's running just a bit slow.
[CUSTOMER][NEUTRAL] Oh, that's OK.
[AGENT][NEUTRAL] Well, I'm not pulling it up by that ID number. Um, do you have the social perhaps for the patient?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] And you needed uh benefits or claim status? I'm sorry.
[CUSTOMER][NEUTRAL] I'm status.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] She's got several different policies. What was she seen for?
[CUSTOMER][NEUTRAL] Well, um, she was, this is an urgent care visit and when I called the 90 degree, they gave me this number because they said they only handle the.
[CUSTOMER][NEUTRAL] The wellness visits.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And she said, they said she had extra coverage so it might be covered, but I would need to call this number.
[AGENT][NEUTRAL] Have you submitted the claim to us?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, did you get a um explanation of benefits yet?
[CUSTOMER][NEUTRAL] No, that's why we're just trying to figure out where the what's going on with the claim. We submitted it 2 times.
[AGENT][NEUTRAL] OK. Let me see.
[CUSTOMER][NEUTRAL] [PII] and then [PII].
[AGENT][NEUTRAL] OK, let me see if I can figure out what's happening here, um.
[AGENT][NEUTRAL] Let's see
[AGENT][NEUTRAL] Just writing down her policy number so I can.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Check the different policies. Um, let's see. OK, so.
[AGENT][NEUTRAL] And do you have the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And what was that date of service again?
[CUSTOMER][NEUTRAL] [PII] for $320.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Like I've got something here.
[AGENT][POSITIVE] Oh, sorry, excuse me, I'm so sorry.
[AGENT][NEUTRAL] Um, let's see, so it looks like.
[AGENT][NEUTRAL] Uh, we paid $100 on this claim.
[AGENT][NEUTRAL] Um, that was on.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No I paid to the physician.
[AGENT][NEUTRAL] That was on. I pulled the date.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] That was on [PII].
[CUSTOMER][NEUTRAL] OK, is there a check number or?
[AGENT][NEUTRAL] Yes, uh, check number 2013528.
[CUSTOMER][NEUTRAL] Do
[CUSTOMER][NEUTRAL] And then is there a patient responsibility?
[AGENT][NEUTRAL] Um, we don't determine patient responsibility. This is just a supplemental policy.
[CUSTOMER][NEUTRAL] OK, and so is $100 just a flat fee that you guys pay?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. All right. Can I get a call reference?
[AGENT][NEUTRAL] Um, yes, it'll just be my first name, [PII], and then my last initial [PII], and then today's date.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK, is there anything else I can help with today?
[CUSTOMER][POSITIVE] That's it, thank you.
[AGENT][POSITIVE] OK, thank you for calling APL have a good afternoon.
[CUSTOMER][NEUTRAL] All right, bye bye.