AccountId: 011433970860
ContactId: f2d28fbf-beeb-4575-9f78-881ee1f65f54
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 488660 ms
Total Talk Time (AGENT): 196150 ms
Total Talk Time (CUSTOMER): 113336 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/f2d28fbf-beeb-4575-9f78-881ee1f65f54_20250203T17:57_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. Hi, my name is [PII]. I'm calling on behalf of Mount Sinai Medical Center. I was calling in regards to a claim issue.
[AGENT][NEUTRAL] Hi [PII].
[AGENT][NEUTRAL] OK, [PII], you have a question regarding a claim?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, I can help you. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] Policy number in question is.
[CUSTOMER][NEUTRAL] 02064134
[AGENT][NEUTRAL] 641-34. Is that correct?
[CUSTOMER][POSITIVE] Mhm, correct.
[AGENT][NEUTRAL] OK. Thank you. So give me a couple of moments to get the member's information pulled up, please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And that any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Carla [PII] 3377.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And do you have, well, first off, what is the data of service and total bill amount?
[CUSTOMER][NEUTRAL] [PII] total charges in question are 1,66824.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry, 1000 and how much?
[CUSTOMER][NEUTRAL] 1,668 24.
[AGENT][NEUTRAL] 668. OK and 24 cents. OK, and the claim number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm, we don't have a claim number as of yet.
[AGENT][NEUTRAL] Oh, I'm sorry. I thought you already had, you already had it. OK, the claim number with a question regarding the claim. You're just trying to check status?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, so I see this claim was received on [PII].
[AGENT][NEUTRAL] 2024, it was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Excuse me, the claim number on here is 354-517-5.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $25.
[AGENT][NEUTRAL] And that was issued on.
[CUSTOMER][NEUTRAL] I was paid once.
[AGENT][NEUTRAL] The same date as the process date.
[AGENT][NEUTRAL] It would have gone through our overnight processing that night.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was on single check?
[AGENT][NEUTRAL] Numbers 2020325.
[AGENT][POSITIVE] And it does still show as outstanding.
[CUSTOMER][NEUTRAL] OK, so I, OK, so I have check number 2020325, is that correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] We're not showing that we've received that and you're saying you're showing it outstanding on your side?
[AGENT][NEUTRAL] Yes sir, what is the PO box on the claim?
[CUSTOMER][NEUTRAL] check up here right now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Should be [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes sir, that is correct. That is where it was sent to.
[CUSTOMER][NEUTRAL] Is there a possibility you could fax me a copy of the EOB please?
[AGENT][POSITIVE] Yes sir, you can actually print it directly from our portal if you can access the internet. We do have a website, Victor, and I can give you that as well. It's secured.
[CUSTOMER][NEUTRAL] OK, OK, go ahead.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And it is a self-registering site, and now that you have a claim number, you should be able to print that.
[AGENT][NEUTRAL] EOB. Now, if you will, yes. Now, for some reason you're not able to do that or I can go ahead and fax this one to you so you can set up the portal for the future. It's in
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] Could you do, could you fax this one and then for future reference I'm gonna just go ahead and sign up. Is that possible?
[AGENT][POSITIVE] Yeah, absolutely. So give me just a moment.
[CUSTOMER][POSITIVE] Mhm, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Tell me when you're ready.
[AGENT][NEUTRAL] Yeah, it takes a moment to load up that for me to fax so.
[CUSTOMER][POSITIVE] No problem. No problem.
[AGENT][NEUTRAL] Does it need to have your attention put on it or is that not necessary? Yes, OK.
[CUSTOMER][NEUTRAL] Please.
[CUSTOMER][NEUTRAL] No, it is attention [PII] and then if you can put this reference number next to it 962-6.
[AGENT][NEUTRAL] One second, [PII]. Hold on.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. What was it again? 962-6?
[CUSTOMER][NEUTRAL] Mhm 7703.
[AGENT][NEUTRAL] OK, just a moment.
[AGENT][NEUTRAL] Bear with me just a second, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] To do something here.
[AGENT][NEUTRAL] OK, what is your fax number, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Again, that's [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that has just been faxed to you so provided there's not any type of technical mishap, you should be receiving that very shortly.
[CUSTOMER][POSITIVE] Perfect, much appreciated for your time, reference number for the call, reference number for the call, please. Mhm.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] You are certainly very welcome, would be my name.
[AGENT][NEUTRAL] Uh-huh, my name and today's date.
[CUSTOMER][NEUTRAL] Is that [PII]?
[AGENT][NEUTRAL] With an eye
[CUSTOMER][POSITIVE] OK, sorry about that.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][POSITIVE] OK, we're good to go. I appreciate it no problem man you have a good one.
[AGENT][POSITIVE] Thank you for asking. OK, [PII]. All right. Well then, you too, and thank you again for calling APL.
[CUSTOMER][POSITIVE] Yes ma'am you have a good one.
[AGENT][POSITIVE] Have a great day. You too. Bye bye.