AccountId: 011433970860
ContactId: f79ec069-1eb4-464e-a5fb-3f0a96650f66
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1016500 ms
Total Talk Time (AGENT): 155391 ms
Total Talk Time (CUSTOMER): 258832 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/f79ec069-1eb4-464e-a5fb-3f0a96650f66_20250616T16:02_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], this is [PII] calling from provider's office to check up on a claim status. Also, this call has been recorded for quality and training purposes. Are you OK with that?
[AGENT][POSITIVE] Yes, right now I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, I do have. It's [PII].
[AGENT][NEUTRAL] Policy number for the patient?
[CUSTOMER][NEUTRAL] Yeah, the policy number would be.
[CUSTOMER][NEUTRAL] 02284016
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, it's
[CUSTOMER][NEUTRAL] Uh, the patient name would be [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Uh, date of service is [PII]. Total charge $500 even.
[AGENT][NEUTRAL] It was [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Don't show a claim on file. Can you resubmit?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Do you have any uh timely filing limit for this one?
[AGENT][NEGATIVE] Uh, no, there's no timely filing limit.
[CUSTOMER][NEUTRAL] And also can you just tell me if the member was active for the date of service like effective date and the term date of the plan?
[AGENT][NEUTRAL] effective date is [PII] and policy is active, no term date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I just need to verify the mailing address. Is it [PII]?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, thank you so much. I can resubmit the claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yeah, can we move to next number?
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] Sure, just a moment.
[CUSTOMER][NEUTRAL] Policy number would be 024.
[CUSTOMER][NEUTRAL] 5098.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Date of service and bill charges?
[CUSTOMER][NEUTRAL] Date of services [PII] total just $405 even 405.
[AGENT][NEUTRAL] I was received 428 25, process [PII] 2025.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And we need a copy of the primary explanation of benefits.
[CUSTOMER][NEUTRAL] Actually we have already submitted that on [PII] through fax.
[AGENT][NEUTRAL] OK, I see that was received 5-13-2025 process [PII].
[AGENT][NEUTRAL] In a payment of 150.
[CUSTOMER][NEUTRAL] OK. Can you help me with the payment details?
[AGENT][NEUTRAL] You'll check number 2045016.
[CUSTOMER][NEUTRAL] OK. And the address?
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] And it's outstanding. Do you want us to?
[CUSTOMER][NEUTRAL] OK, do you have any?
[CUSTOMER][NEUTRAL] Yeah, can you send this for?
[CUSTOMER][NEUTRAL] reissued again because we didn't receive any payment yet.
[AGENT][NEUTRAL] OK, I'll get that sent back through. It takes 7 to 10 working days.
[CUSTOMER][NEUTRAL] Um, 7 to 10.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] Can you help me with the claim number?
[AGENT][NEUTRAL] My number is 359-564-6.
[CUSTOMER][NEUTRAL] OK, it's the same.
[AGENT][NEUTRAL] Oh, I'm sorry, it's 3602286.
[CUSTOMER][NEUTRAL] 28360286 that's it?
[AGENT][NEUTRAL] 3602286.
[CUSTOMER][NEUTRAL] 2286. OK.
[CUSTOMER][NEUTRAL] And the pay date was [PII], right?
[AGENT][NEUTRAL] [PII], yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you. Can we move to next number?
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] Um, yeah, the policy number would be 02260491.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Date of service and bill charges.
[CUSTOMER][NEGATIVE] It's [PII] total charge $450 even $450 and actually I do have some concern with this claim.
[AGENT][NEUTRAL] What what was the date of servicing?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And what was the bill charges?
[CUSTOMER][NEUTRAL] $450 even $450.
[AGENT][NEUTRAL] You had a question on the claim. Do you have the claim number?
[CUSTOMER][NEUTRAL] Yes, I do have.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] It's 354-1340.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like we had put in for a void of the check.
[AGENT][NEGATIVE] The issue.
[CUSTOMER][NEUTRAL] Yeah, the check was sent to be reissued.
[AGENT][NEUTRAL] Check, hold on one more.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] I'm just checking to see and make sure what if the turnaround time is correct that I gave you.
[AGENT][NEUTRAL] Hold on one moment, OK?
[CUSTOMER][NEGATIVE] Yeah, sure. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] Fucking shit, dude.
[AGENT][NEUTRAL] OK, I'm not sure why I, I don't show it reissued yet, so I'll have to follow up on that with our department that does that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So are you going to uh send this one?
[AGENT][NEUTRAL] Yes, uh-huh.
[CUSTOMER][NEUTRAL] Um, OK, sure.
[CUSTOMER][NEUTRAL] Can you help me?
[CUSTOMER][NEUTRAL] With the turn around time?
[AGENT][NEUTRAL] Uh, I mean, it should take 10 working days, so I'm not sure what happened to it, so.
[CUSTOMER][NEUTRAL] Can I just check once if the claim has been paid to a member?
[CUSTOMER][NEUTRAL] By any chance?
[AGENT][NEGATIVE] No, it's not been paid to the member.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Um, yeah, thank you so much.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] Is there anything else I can help with today?
[CUSTOMER][NEUTRAL] The claim number remains the same actually I do have one more claim. Can you help me with that one as well?
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] OK, the number.
[CUSTOMER][NEUTRAL] Your is also the same, yeah, it's 017.
[CUSTOMER][NEUTRAL] 41606.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Member's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Date of service and bill charges?
[CUSTOMER][NEUTRAL] Detail service is [PII]. Total charge $450 even $450.
[CUSTOMER][NEUTRAL] This one was also sent uh to be reissued the check.
[AGENT][NEUTRAL] What's the claim number?
[CUSTOMER][NEUTRAL] Claim number was 3,541,250.
[AGENT][NEUTRAL] And when did you send for check reissue?
[CUSTOMER][NEUTRAL] It was on [PII].
[AGENT][NEUTRAL] Um, we had a call that day for claim status, and then we sent the EOB to the fax number.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, you have submitted uh.
[AGENT][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I don't see a check, uh, request for check void and reissue though just request a claim status and then EOB.
[AGENT][NEUTRAL] Um, but I don't show the check is cleared, so I'll get that sent through as well.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] That would be the same.
[AGENT][NEUTRAL] Yes, the same, same number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Is there anything else I can help with today?
[CUSTOMER][NEUTRAL] Uh, can you help me with the call reference number?
[AGENT][NEUTRAL] That's my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, [PII]. Thank you so much for your help. Hope you have a wonderful day. Thank you.
[AGENT][POSITIVE] Thank you
[AGENT][POSITIVE] You feel. Have a good day. Bye-bye.