AccountId: 011433970860
ContactId: f5999557-e2b1-411c-8765-eef91d586ea3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1348099 ms
Total Talk Time (AGENT): 428137 ms
Total Talk Time (CUSTOMER): 243167 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/f5999557-e2b1-411c-8765-eef91d586ea3_20250326T17:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I'm calling to check claim status.
[AGENT][NEUTRAL] I'm sorry, may I have your name again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you [PII]. What is your callback number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And what is your policy number, please?
[CUSTOMER][NEUTRAL] Policy number 01.
[CUSTOMER][NEUTRAL] 256
[CUSTOMER][NEUTRAL] 021.
[AGENT][NEUTRAL] OK, thank you. Let me just repeat that to confirm. I have that as 01256021.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, it isn't [PII]. It's [PII]
[CUSTOMER][NEUTRAL] Date of birth? February, I mean, [PII].
[AGENT][NEUTRAL] Thank you for the verification process, [PII], and again, you're calling for claim status. I can assist you. What is the date of service and the total charge amount?
[CUSTOMER][NEUTRAL] Day of service here would be 10-7-2024 and the total bill amount here one moment.
[CUSTOMER][NEUTRAL] It's for $471.
[AGENT][POSITIVE] OK, thank you very much one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I do not show this claim under this policy number. Um, this particular policy termed as of [PII].
[AGENT][NEUTRAL] And again the policy does not have this claim under. Let me check to see if there's an active policy for you within that date range perhaps one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you for your patience. I was able to locate the policy that has that claim under and that policy, the correct policy number is.
[AGENT][NEUTRAL] 022958
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] One moment, one moment, trying to get back over there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 022.
[AGENT][NEUTRAL] 958007.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And that claim shows that denied. Um, give me one second, please.
[AGENT][NEGATIVE] Actually it denied, we received it twice. It denies a duplicate. The first submission we paid $189.40.
[CUSTOMER][NEUTRAL] And that would state on which date.
[AGENT][NEUTRAL] I'll get the information for you in just a moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, that was processed on [PII].
[AGENT][NEUTRAL] And that claim number shows.
[AGENT][NEUTRAL] 354-888-88.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and the check number shows 2021913.
[CUSTOMER][NEUTRAL] 0 202.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 19
[CUSTOMER][NEUTRAL] 19
[AGENT][NEUTRAL] 13.
[CUSTOMER][NEUTRAL] Number 2021913.
[AGENT][NEUTRAL] Yes, and actually that check shows as currently outstanding. Let me just verify that mailing address it was mailed to. One moment please.
[AGENT][NEUTRAL] OK. The check was mailed to [PII].
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Since it has been
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] Since it has been in excess of 30 days, I can request the check to be voided and a new check reissued.
[CUSTOMER][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] And your name again?
[AGENT][NEUTRAL] You're welcome. My name is [PII]. Last initial is [PII], and [PII], we do not provide reference numbers, but you can use my name in today's date, and you can also check claim status by visiting our secure portal at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and to recap the call one more, we talked about claim number 354-8888. That check number was 2021913, and the amount of 18,940. That check currently shows outstanding, so I will put that request in to have it voided and a new check reissued mailed to the same address.
[CUSTOMER][NEUTRAL] Right, and I do have other claims.
[AGENT][NEUTRAL] And just a reminder you can also check claim status on that secure website um Lamo one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, what is the policy number?
[CUSTOMER][NEUTRAL] Yes, this next member's policy number here would be 022.
[CUSTOMER][NEUTRAL] 81881.
[AGENT][NEUTRAL] OK, that was 02281881. Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Date of birth? [PII].
[AGENT][NEUTRAL] What's that date of service and then fill them out please.
[CUSTOMER][NEUTRAL] Data service 725 2024 total amount billed $260.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, that's, we received that claim and made a payment in the amount of $82.01 and that check also shows.
[AGENT][POSITIVE] Outstanding and it was mailed to the same address as previous 8 and that claim number shows 354-897-8.
[CUSTOMER][NEUTRAL] Wait, 354-897-8?
[AGENT][NEUTRAL] Yes, and that check number is 2021931.
[CUSTOMER][NEUTRAL] 2021931
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] Oh, it's the same check 20219.
[CUSTOMER][NEUTRAL] 13
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Is that the same check? It looks like the same check.
[AGENT][NEUTRAL] No, no. This check is, the first check was 2021913.
[AGENT][NEUTRAL] This check is 2021931.
[CUSTOMER][NEUTRAL] OK, 31, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it was mailed to the same address as before.
[AGENT][NEUTRAL] And that check was issued on [PII] and that check can be also voided and reissued and paid to the same address.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have another date of service for this member?
[CUSTOMER][NEUTRAL] No different number.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] This next number, um, policy number here is 1337111.
[AGENT][NEUTRAL] OK, that was 133-7111. Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] OK, and what's the date of service and bill amount?
[CUSTOMER][POSITIVE] The oh no worries, it seems like it's already paid.
[CUSTOMER][POSITIVE] No worries, it seem like it's already been taken care of. Let me check this other one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have a different member another claim.
[AGENT][NEUTRAL] OK, what's that policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Policy number here would be.
[CUSTOMER][NEUTRAL] 2021.
[CUSTOMER][NEUTRAL] I apologize. 0231510.
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] OK, that was 02315108. Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] oh wait, [PII].
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][NEUTRAL] OK, and when is the date of service and boiled amount please.
[CUSTOMER][NEUTRAL] Total, uh, data service I mean data service 722 2024 total bill amount would be uh oh this claim is broken up come on here, uh, first one is $494.
[CUSTOMER][NEUTRAL] And I have one for $88 same patient.
[AGENT][NEUTRAL] OK, so that's [PII], 1 for $494.01 for $88.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, we received the claim that was billed for $494. We made a payment of $15766.
[AGENT][NEUTRAL] Let me check the status of that check one moment.
[CUSTOMER][NEUTRAL] And this was paid on which day?
[AGENT][NEUTRAL] I'm about to check the status of the check one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Actually that was processed today but there is no check number.
[AGENT][NEUTRAL] Again that claim was processed today.
[AGENT][NEUTRAL] And that check is in the amount will be in the amount of $157.66.
[AGENT][NEUTRAL] Now the claim for $88. 1 moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is the claim number for this one?
[AGENT][NEUTRAL] Claim number is 358-0796.
[CUSTOMER][NEUTRAL] 358-096
[AGENT][NEUTRAL] No, 358-079-6.
[CUSTOMER][NEUTRAL] OK, 7, OK, because the phone had broken up. Thank you.
[AGENT][POSITIVE] OK, you're welcome.
[AGENT][NEUTRAL] OK, for the claim for $88.01 moment.
[AGENT][NEUTRAL] back to the.
[AGENT][NEUTRAL] How wise because
[AGENT][NEUTRAL] OK, we received that claim on [PII]. It is in line to be reviewed and processed, so there is no claim number attached to it.
[CUSTOMER][NEUTRAL] And that was received on [PII]?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hey, you know this stuff.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me make sure.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, [PII], and it seems I have one last claim.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, what's that policy number?
[CUSTOMER][NEUTRAL] Yes, this policy number here.
[CUSTOMER][NEUTRAL] Would be um 021502.
[CUSTOMER][NEUTRAL] 32.
[AGENT][NEUTRAL] OK, I have that as 02150232.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you. Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] This patient's name here would be [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, what is the total charge amount and the date of service?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Total bill amount is $500.
[CUSTOMER][NEUTRAL] The the service is
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, this particular policy turned as of [PII].
[AGENT][NEUTRAL] And the claim is not on this policy. One moment, let me check for a policy with that date range.
[AGENT][NEUTRAL] $500.
[AGENT][NEUTRAL] OK, we received the claim and made a payment.
[AGENT][NEUTRAL] In the amount of $250.
[AGENT][NEUTRAL] That was paid on [PII].
[AGENT][POSITIVE] And currently the check also shows outstanding.
[AGENT][NEUTRAL] The claim number is
[AGENT][NEUTRAL] 354 8971.
[AGENT][NEUTRAL] And the check number is.
[AGENT][NEUTRAL] 2021932.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, it was mailed to the same address as previously.
[AGENT][NEUTRAL] And I will put a void request to have that check voided and a new check reissued.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One
[AGENT][NEUTRAL] And again that check number was 20 you're welcome and that check number is 2021932.
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Uh-huh. 20.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] OK, you're welcome. Anything else I can help you with?
[CUSTOMER][POSITIVE] That would be all for now. Thank you kindly and have a beautiful day.
[AGENT][POSITIVE] And you as well and thank you for calling APL. Take care bye bye.
[CUSTOMER][POSITIVE] Thank you bye bye.