AccountId: 011433970860
ContactId: 00120865-16e4-49b9-a232-b58494ddce83
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167460 ms
Total Talk Time (AGENT): 45015 ms
Total Talk Time (CUSTOMER): 65616 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/00120865-16e4-49b9-a232-b58494ddce83_20250605T17:00_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from provider office to check up on a claim status. Could you please help?
[AGENT][POSITIVE] I'll be happy to assist with claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Yes, my callback number is [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 0183897979.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Patient name is uh [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] And what's the date of service for the claim?
[CUSTOMER][NEUTRAL] There of services, [PII].
[AGENT][NEUTRAL] And the tax ID.
[CUSTOMER][NEUTRAL] The tax ID number is [PII].
[AGENT][NEUTRAL] Thank you for that information. I'm showing the claim was denied because the maximum per occurrence benefit was maxed out before we received the claim.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] No, OK, whether it is uh
[CUSTOMER][NEUTRAL] May I know the maximum benefit rates in terms of $1 or visits?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So the per occurrence maximum is $200 and that had already been paid out on on a different claim to a different provider.
[CUSTOMER][NEUTRAL] For the same patient, is that correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. May I have the
[CUSTOMER][NEUTRAL] Claim number for that?
[AGENT][NEUTRAL] Claim number is 349-60007.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK, [PII], can I have the record number for this call?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Uh, no, sir. That's all for today. Thank you for asking.
[AGENT][POSITIVE] Thank you for calling APL you have a good day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye.