AccountId: 011433970860
ContactId: ea9eb6f8-45a0-4e84-9aed-6dce0ee96d23
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 555719 ms
Total Talk Time (AGENT): 193260 ms
Total Talk Time (CUSTOMER): 203521 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/ea9eb6f8-45a0-4e84-9aed-6dce0ee96d23_20250123T13:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. This is [PII]. Last [PII] calling from provider's office looking for claims status.
[AGENT][NEUTRAL] Can I help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Uh yeah. 01638489 M as in Mary, L as in Lima, number 8.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII] and the extension is [PII].
[AGENT][NEUTRAL] [PII], you can also check your status on our online service center at [PII] as well, and I can help you set that account up if you would like.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you can verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yeah, the patient's name is [PII]. [PII].
[AGENT][NEUTRAL] Thank you. And what's the date of service and the total bill amount?
[CUSTOMER][NEUTRAL] Yeah, [PII] with the billed amount $974.06.
[AGENT][NEUTRAL] OK, so it's a facility charge or professional fee?
[CUSTOMER][NEUTRAL] Yeah, the facility is Miami Hematology and Oncology Associate.
[AGENT][NEUTRAL] OK, what are the procedure codes on the claim?
[CUSTOMER][NEUTRAL] Uh yeah. 9 963-659921396367. J 2916 and J 1200.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Only $50.
[AGENT][NEUTRAL] So I show this claim was received [PII].
[AGENT][NEUTRAL] Process [PII], uh, issuing a payment of $133.86.
[CUSTOMER][NEUTRAL] This was [PII].
[AGENT][NEUTRAL] Let me know when you're ready for the claim number.
[CUSTOMER][NEUTRAL] OK, what is the paid amount?
[AGENT][NEUTRAL] 133.86.
[CUSTOMER][NEUTRAL] Yeah, what is the
[CUSTOMER][NEUTRAL] OK. May I know the claim number, please?
[AGENT][NEUTRAL] 354.
[AGENT][NEUTRAL] 7305.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] OK. Paid VIFT or check number?
[AGENT][NEUTRAL] That's an individual check. Check number is 202.
[AGENT][NEUTRAL] 125 7.
[CUSTOMER][NEUTRAL] OK, and check that.
[AGENT][NEUTRAL] The date that it was processed.
[CUSTOMER][NEUTRAL] Of
[CUSTOMER][NEUTRAL] OK, can you please fix uh your
[AGENT][NEUTRAL] OK, the email the ELB was mailed to the address that's on the claim submitted and it can also now be downloaded from the online service center at [PII].
[AGENT][NEUTRAL] So do you want me to help you create that account?
[CUSTOMER][NEUTRAL] No, we don't have an account on that.
[AGENT][NEUTRAL] Do would you like for me to assist you with creating an online account?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, let me know when you're ready for the web address.
[CUSTOMER][NEUTRAL] Yeah, please go ahead.
[AGENT][NEUTRAL] OK, it's secured, so that's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] And let me know when you're at the home page.
[CUSTOMER][NEUTRAL] Yeah, just a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, so it shows on the option that.
[CUSTOMER][NEUTRAL] American fidelity systems are currently offline.
[CUSTOMER][POSITIVE] I love
[AGENT][NEUTRAL] So on the home page you should see online service center welcome.
[AGENT][NEUTRAL] On the homepage. Do you see that?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, so this shows is uh this, uh this uh page is current, currently in offline due to system.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, what web address did you use? Could you repeat that to me?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Secured [PII].
[AGENT][NEUTRAL] It's secured. [PII].
[CUSTOMER][POSITIVE] Right, right, correct.
[AGENT][NEUTRAL] And you're receiving which message?
[CUSTOMER][NEUTRAL] OK. So I'm showing the screen. American Fidelity systems are currently offline. We are actually working to restore our services.
[AGENT][NEUTRAL] Mm mm it's not down. I'm looking at the home page.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you entered [PII]?
[CUSTOMER][POSITIVE] Yeah, that, that is correct. That is a page.
[AGENT][NEUTRAL] OK, can you email me a copy of that, the error message that you're receiving?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] No, we don't allow to send it.
[AGENT][NEUTRAL] OK, and so the ELB was processed on the [PII]. I would allow more time to receive it?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. Your car reference number?
[AGENT][NEUTRAL] You'll use my name in today's date, [PII]
[AGENT][NEUTRAL] And first initial of my last name is [PII].
[AGENT][NEUTRAL] And before I release the line, can you verify the billing address?
[CUSTOMER][POSITIVE] OK, thank.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] On the claim?
[CUSTOMER][NEUTRAL] Yeah. [PII].
[AGENT][NEUTRAL] Give me that one more time please.
[CUSTOMER][NEUTRAL] Sure. It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, I'm showing a different mailing address on the claim.
[CUSTOMER][NEUTRAL] OK, so it's maybe it's an [PII], right?
[AGENT][NEUTRAL] Yeah, we, we send it to the mailing address. It's in [PII], not [PII].
[AGENT][NEUTRAL] So are you looking at the claim form?
[CUSTOMER][POSITIVE] No. Thank you. Thank you so much.
[AGENT][NEUTRAL] All right. Can you verify the address that's on the claim fo[PII]?
[AGENT][NEUTRAL] In [PII]. Uh-huh.
[CUSTOMER][NEUTRAL] Uh, yeah, just a moment.
[CUSTOMER][NEUTRAL] Yeah, just a moment.
[CUSTOMER][NEUTRAL] Sorry, I.
[CUSTOMER][NEUTRAL] French
[CUSTOMER][POSITIVE] my best.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] The address [PII]st be [PII], [PII], right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What city and state do you show?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yeah, uh, the city is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] On can I.
[AGENT][NEUTRAL] I'm showing [PII], but that's the address that the uh EOB was mailed to along with the check.
[CUSTOMER][NEUTRAL] Yeah, yeah, [PII].
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] Are you, are you at that location or does it go to a different location from where you are?
[CUSTOMER][POSITIVE] Yeah, that is correct. That is correct.
[AGENT][NEUTRAL] Are you at that location? Does a claim come to your location or does it go somewhere else?
[CUSTOMER][NEUTRAL] Yeah. Yeah. OK. How many days it will take to be received for the mail?
[AGENT][NEUTRAL] Oh, we cannot verify that once it's released from our office, we can't, you know, negate how long it'll take to get to the provider's office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII].
[AGENT][NEUTRAL] All right, [PII], anything else?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] Alrighty thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] And