AccountId: 011433970860
ContactId: fc17421f-a11e-4e2b-8fe3-0764ae9ce34b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 345720 ms
Total Talk Time (AGENT): 155278 ms
Total Talk Time (CUSTOMER): 79993 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=2.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/fc17421f-a11e-4e2b-8fe3-0764ae9ce34b_20250410T18:34_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and my last name initial is [PII]. I'm calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing to check one claim status. Is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] Yes, sir, I can help you with that. And [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] Sure. The callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] Sure, the member's policy number is 228.
[CUSTOMER][NEUTRAL] 6119.
[AGENT][NEUTRAL] OK, [PII], thank you. Give me a moment please to get the member's information pulled up.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and [PII], 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 their date of birth, please?
[CUSTOMER][NEUTRAL] Yes, the date, the patient's name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] The rate of service is [PII] and the total bill amount is $811.23.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you again that data service was 221 of 2025 for 811.23. Is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so the claim was processed received for 4, this request processed on [PII].
[AGENT][NEUTRAL] The claim number [PII] is 358-546-4.
[AGENT][NEUTRAL] There has been a benefit issued in the amount of $25.
[AGENT][NEUTRAL] And that was issued on claim number 3585464.
[AGENT][NEUTRAL] And the remark on this claim states with this payment.
[AGENT][NEUTRAL] The maximum benefit amount.
[AGENT][NEGATIVE] For services provided during this office visit is exhausted.
[CUSTOMER][NEUTRAL] OK, so uh this was denied, right?
[AGENT][NEUTRAL] No, sir, I just explained that this was paid. There was a $25 benefit and with this payment, the maximum benefit amount for services provided during this office visit is exhausted.
[CUSTOMER][POSITIVE] Got it. Perfect. And do you have any uh payment details like EFT number or check number?
[AGENT][NEUTRAL] The single check number is 2037441.
[AGENT][NEUTRAL] And that was issued on [PII].
[AGENT][NEUTRAL] 3 days ago.
[CUSTOMER][POSITIVE] OK, got it. Thank you so much. And uh sorry I just missed out your name. Can you repeat that for me, please?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, my name is [PII] First initial to my last name, [PII].
[AGENT][NEUTRAL] You will use my name and today's date if you need a call reference number.
[AGENT][NEUTRAL] And also [PII], if you need a copy of this explanation of benefits, you may print that by going to our portal.
[AGENT][NEUTRAL] And our website for the portal is [PII].
[CUSTOMER][POSITIVE] OK, got it. Uh, yes, that was all, [PII]. Thank you for providing the details. You have been a great help. Have a wonderful day today.
[AGENT][NEUTRAL] Well, you're very
[AGENT][POSITIVE] Well, I hope you do too, [PII]. Is there anything else I could help you with?
[CUSTOMER][NEUTRAL] Uh, no, that was all, and, uh, yes, that was all actually.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK then well thank you again for calling APO and I hope you have a nice day.
[CUSTOMER][POSITIVE] You too bye bye take care.
[AGENT][POSITIVE] Thank you. You too.