AccountId: 011433970860
ContactId: f85c95d2-1f00-45a9-883f-343d5ee445e4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 353559 ms
Total Talk Time (AGENT): 152596 ms
Total Talk Time (CUSTOMER): 96791 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/f85c95d2-1f00-45a9-883f-343d5ee445e4_20250213T18:48_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] Hi, this is [PII] calling from road office to check the claim status.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][POSITIVE] Yes, I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] My number is [PII].
[AGENT][NEUTRAL] OK. I'm having trouble hearing you, [PII].
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you and your patient's policy number?
[CUSTOMER][NEUTRAL] Policy number is 02544684.
[AGENT][POSITIVE] Thank you, one moment please.
[CUSTOMER][NEUTRAL] Can I get your name, please?
[AGENT][NEUTRAL] Yes, again my name is [PII] and my name and today's date will also be your call reference number if you need one.
[AGENT][NEUTRAL] And any information [PII] 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 their date of birth, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, patient name is [PII]. Last name is [PII], and patient number is [PII].
[AGENT][NEUTRAL] OK, so we have the first name is [PII].
[AGENT][NEUTRAL] And last name is [PII].
[CUSTOMER][NEUTRAL] OK. Uh sorry, it's my mistake.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is the date of service and total bill amount?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] The service is [PII] and the bill amount is $528 even.
[AGENT][NEUTRAL] OK, again that was [PII] for $528 is that correct?
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] OK, so this claim was received. I show that the received date, one moment, the received date on this claim is going to be.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 121, 2025.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] E
[AGENT][NEUTRAL] The claim number is 3555496.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm, OK. And
[AGENT][POSITIVE] There was a benefit
[CUSTOMER][NEUTRAL] Yeah, previously, uh, we got, uh, request the payment details. Uh, payment of post to the $50 I paid and there is a remaining balance of $478 even. What is that actually?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] We do not determine patient responsibility, that would be up to the provider.
[AGENT][NEUTRAL] This is not a major medical plan. This is not a major medical plan. This is a limited benefit plan so again APL does not determine patient responsibility.
[CUSTOMER][NEUTRAL] It's a provide a discount, right?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, it's a provide a discount, right?
[AGENT][NEUTRAL] The provider would determine patient responsibility.
[CUSTOMER][NEGATIVE] What is it? I can't understand.
[CUSTOMER][NEUTRAL] Can you please repeat one more time?
[AGENT][NEUTRAL] APL does not determine patient responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's like provide a write off or provide a discount I'm asking. What is it?
[AGENT][NEUTRAL] You would have to contact.
[AGENT][NEUTRAL] Multipla regarding any discount questions.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get uh
[CUSTOMER][NEUTRAL] Can I get the multiple number for this?
[AGENT][NEUTRAL] I'm sorry. What was your que I can barely hear you. What was your question?
[CUSTOMER][NEUTRAL] To contact
[CUSTOMER][NEUTRAL] No, no, we need to verify the amount, remaining balance, so we need to, you said you need to contact multiplan, so I request the number to call for that.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, could you please repeat one more time?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Can I transfer the call to them?
[AGENT][NEUTRAL] I can, and if you need a copy of the explanation of benefits that we just discussed, you may print that by going to our portal at [PII]. Give me just one moment before I look before I transfer you. Let me look at one thing on this policy please, [PII], one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][POSITIVE] OK, so if you will give me one moment, if that's all thing that I can help you with, I'll be happy to connect you.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][POSITIVE] OK, well thank you again for calling [PII] and I hope you have a nice afternoon.