AccountId: 011433970860
ContactId: f35c944d-9449-4b7f-9bbd-6ce7b85b894d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 461179 ms
Total Talk Time (AGENT): 191446 ms
Total Talk Time (CUSTOMER): 227358 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/f35c944d-9449-4b7f-9bbd-6ce7b85b894d_20250210T21:25_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Hi, hello, this is [PII], and I would like to confirm, uh, how much IPL will pay for a claim.
[CUSTOMER][NEUTRAL] Um, I would like to confirm that with you.
[AGENT][NEUTRAL] OK, so you need to check and see how much we paid for a claim.
[CUSTOMER][NEUTRAL] Well, yes, that uh APL will pay. I think it's uh in.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] We
[CUSTOMER][NEUTRAL] The status is like uh current. It has not been paid already.
[AGENT][NEUTRAL] OK, I can check claim status and see what's going on with the claim. OK, Ms. [PII], um, what is the callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh yes, uh [PII].
[AGENT][NEUTRAL] OK, and do you have the policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] go ahead with the number.
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] Number, do you need that, the group number?
[AGENT][NEUTRAL] Yes, no, I need the account number which is the one in the bottom where it says outpatient start.
[CUSTOMER][POSITIVE] Exactly
[CUSTOMER][NEUTRAL] OK. It is [PII].
[CUSTOMER][NEUTRAL] 146644.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] All right. And may I have your date of birth for security?
[CUSTOMER][NEUTRAL] Yes, of course. It is [PII].
[AGENT][NEUTRAL] OK, and I need to verify the mailing address, email address, and um, so for verification.
[CUSTOMER][NEUTRAL] Yes, the address is [PII].
[AGENT][NEUTRAL] All right. And what's the email address?
[CUSTOMER][NEUTRAL] It is uh [PII].
[AGENT][NEUTRAL] All right. And let's see, what is the date of service or the claim number?
[AGENT][NEUTRAL] What information do you have?
[CUSTOMER][NEUTRAL] It is a claim about uh Baptist Hospital.
[CUSTOMER][NEUTRAL] Uh, [PII]. Right now I don't have the, the claim number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But it's about, uh, yes, I, I did have a delivery, uh, a baby delivery.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, so we send a check in the amount of $1,387.80 to Baptist.
[CUSTOMER][NEUTRAL] And the total was like uh 1400 and something like that.
[AGENT][NEUTRAL] The total was $1,387.80.
[CUSTOMER][NEUTRAL] OK, because I have a, a number that the Baptist Hospital gave me about 1400.
[CUSTOMER][NEUTRAL] And uh it is not, uh, I, I just want to be sure it's the same one.
[CUSTOMER][NEUTRAL] It is just one claim, right? That's the total, so APL take the 100%.
[AGENT][NEUTRAL] Um, let me check.
[AGENT][NEUTRAL] From Baptist, we pay the facility charges and that was the facility bill. Um, we don't know if they have any other bills out there, um, but the one we did receive was the for the for the facility for Baptist Facility Hospital and it was for the 1380.
[AGENT][NEUTRAL] $7.80 and we, we did send out that payment. Um, now, we don't know if they have any other bills for any other charges besides the facility and you might want to call them and check and see if it was for the facility or if it was for doctors charges or what exactly are they're trying to charge.
[CUSTOMER][NEUTRAL] OK, yes, because I talked with them last week or a week before, I'm not sure and they told me that uh they hadn't received any payment from APL but now you are telling me that uh APL already sent, right? uh a check.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We send this check out, um, let me see, it was processed on the [PII], um, let me see exactly what day it went out. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] And my coverage is for outpatient and inpatient. I have both.
[AGENT][POSITIVE] Mhm. Yes, correct.
[CUSTOMER][NEUTRAL] So I would like to know if I. Uh-huh. APL is just processing the one claim, or do I need to give you the other number for the inpatient so you can check if there are both. There are two claims.
[AGENT][NEUTRAL] It's the same.
[CUSTOMER][POSITIVE] It's the same. OK, perfect.
[AGENT][NEUTRAL] Mhm. Yes, it's the same everything is the same, yes. So, um, it looks like this was processed on [PII], um, so the check went out on the [PII].
[AGENT][NEUTRAL] Of January.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. OK, so I will check that then uh with the Baptist Hospital.
[AGENT][NEUTRAL] Do you need the check numbers so you can review that with them?
[CUSTOMER][NEUTRAL] Yes, please, let, give me a second so I can uh take note.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Uh yes, I'm ready.
[AGENT][NEUTRAL] OK, the check number is 202.
[AGENT][NEUTRAL] 26
[CUSTOMER][NEUTRAL] Oh, can you say that again?
[AGENT][NEUTRAL] 202.
[CUSTOMER][NEUTRAL] 202 uh-huh.
[AGENT][NEUTRAL] 26
[AGENT][NEUTRAL] 18.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so let me confirm, it is 202-2618?
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] Well, thank you very much.
[AGENT][NEUTRAL] Oh, you're welcome, Ms. [PII]. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Uh, if I
[CUSTOMER][NEUTRAL] Uh, in some other moment I would like to know how much it will cost for my family to have APL because right now my employer pays for me, for my coverage, but I would like to know for my son and my husband, uh, it's the same number that I that I will need to call to, to have that uh.
[CUSTOMER][NEUTRAL] Quote,
[AGENT][NEUTRAL] We, OK, we don't have any individual policies, so it will have to be through your employer. Um, you will have to check with your employer and see if you can add your spouse and your dependents and see if, uh, how much will be, you know, they will go ahead and take out of your check. But yeah, we don't have any individual policies, it has to be through your employer.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][POSITIVE] OK, I understand. Well, thank you so much.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that would be all. Thank you.
[AGENT][POSITIVE] Mm, you're welcome and thank you for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you, bye bye.