AccountId: 011433970860
ContactId: ec4635e6-7b68-4bdc-9888-2d1a1f075797
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 692159 ms
Total Talk Time (AGENT): 198423 ms
Total Talk Time (CUSTOMER): 131468 ms
Interruptions: 2
Overall Sentiment: AGENT=1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/ec4635e6-7b68-4bdc-9888-2d1a1f075797_20250121T13:17_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, good morning [PII]. This is [PII] calling from Sinai Medical Center. I need to get the status of the claim.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status for one patient, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And like 2 or 3 right now.
[AGENT][NEUTRAL] 2 or 3 different patients or 2 or 3 claims for the same patient.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Different vision.
[AGENT][POSITIVE] Yes, I can help you with that.
[AGENT][NEUTRAL] And [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And [PII], you will use my name that I gave you as along with today's date is your call reference number. Also, any information that I provide on any of the claims will be a verification of benefits and not a guarantee of payment. And lastly, if you need a copy of any of our explanation of benefits, you may go to our portal at [PII].
[AGENT][NEUTRAL] So what is your first patient's policy number, please?
[CUSTOMER][NEUTRAL] It will be.
[CUSTOMER][NEUTRAL] 01810313.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And what is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, what is the date of service and total bill amount, please, [PII].
[CUSTOMER][NEUTRAL] [PII] with the billed amount of 5,77584 after primary paid 1,68147.
[AGENT][NEUTRAL] One moment, please.
[AGENT][NEUTRAL] OK, and [PII], this claim was received. It was received on [PII], processed on [PII]. The claim number is 354.
[AGENT][NEUTRAL] 9741.
[AGENT][NEUTRAL] There was a
[CUSTOMER][NEUTRAL] 354971.
[AGENT][NEUTRAL] No, no, after the 7, it's 41.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the bill and the paid amount was the $1,681.47.
[AGENT][NEUTRAL] And the check number was 2022145.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 145.
[CUSTOMER][NEUTRAL] And paid on January.
[AGENT][NEUTRAL] The process date. Mm.
[CUSTOMER][NEUTRAL] When was that?
[AGENT][NEUTRAL] Do you need for me to give you the process date again? [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, on [PII].
[AGENT][NEUTRAL] And do you need any other information on this one before I?
[CUSTOMER][NEUTRAL] None this far no.
[AGENT][NEUTRAL] Finish my portion. This one, you're good on this one?
[AGENT][NEUTRAL] Did you say yes, [PII]? You don't need anything else? OK.
[CUSTOMER][NEGATIVE] No, uh, no, no, I said no.
[AGENT][NEUTRAL] OK, and what is your next policy number?
[CUSTOMER][NEUTRAL] That is 02517427.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the data service and total bill amount.
[CUSTOMER][NEUTRAL] [PII] fill amount 3970 with 39 cents after primary pay 2120 even.
[AGENT][NEUTRAL] The total bills again, again, you said it was 3970.39 and then 2120 was after insurance, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, so this claim has been received twice. The most recent one was received as a duplicate. Do you need the original claims information?
[CUSTOMER][NEUTRAL] Um, the original, yes, because, um, called on [PII]. I was advised that the claim was not received.
[AGENT][NEUTRAL] Because it was also received that same day. So you must have.
[AGENT][NEUTRAL] You must have called maybe before it was processed into the system, but we did receive a claim that date as well. OK, so the claim number is 3549562.
[CUSTOMER][NEUTRAL] 9562 OK.
[AGENT][NEUTRAL] Uh-huh. And there was a benefit paid in the amount of 2120.
[CUSTOMER][NEUTRAL] When it was received.
[AGENT][NEUTRAL] 16
[CUSTOMER][NEUTRAL] The original plan.
[AGENT][NEUTRAL] And processed on 19.
[AGENT][NEUTRAL] And then, do you want the check number for that?
[CUSTOMER][NEUTRAL] When it was received.
[AGENT][NEUTRAL] 16.
[CUSTOMER][NEUTRAL] 16.
[CUSTOMER][NEUTRAL] Give me a moment, OK, hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What is the check number?
[AGENT][NEUTRAL] 202-2219.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That was a single payment, right?
[AGENT][NEUTRAL] Yes, ma'am, all of our payments are single.
[CUSTOMER][NEUTRAL] OK, for this one that was 4.
[AGENT][NEUTRAL] That's all? Is that all for this one?
[CUSTOMER][POSITIVE] For this member, yes.
[AGENT][NEUTRAL] And you do have another one?
[CUSTOMER][NEUTRAL] Yes, give me a moment.
[CUSTOMER][POSITIVE] Actually right now that was all thank you very much appreciate it.
[AGENT][POSITIVE] Oh, well, you're certainly welcome, [PII]. So if that is all for the moment I can help you with, thank you again for calling APO and I hope you have a great uh day today.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.