AccountId: 011433970860
ContactId: 0e86d3b3-783f-4bf1-a231-d234eb179369
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195160 ms
Total Talk Time (AGENT): 53692 ms
Total Talk Time (CUSTOMER): 91668 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/0e86d3b3-783f-4bf1-a231-d234eb179369_20250416T15:27_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]. I'm calling from Tidal Health [PII], and I was calling regarding a remit that I've received as a 0 payment, um, and I just wanted to get a little bit of information or more information if you have it.
[AGENT][NEUTRAL] On the claim, OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right. What's the policy number?
[CUSTOMER][NEUTRAL] That is 02140646.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] up here.
[AGENT][NEUTRAL] And then [PII], if I could get patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient name is, I think it's [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, and then what are we looking for on the data service?
[CUSTOMER][NEUTRAL] Um, data service is 23 of 25.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I believe the charges are 9-1408. Well, no, that's not right.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It's another claim sorry.
[AGENT][POSITIVE] That's OK. No, no worries.
[CUSTOMER][NEUTRAL] I was looking at another claim, um.
[CUSTOMER][NEUTRAL] Just send 300065293701.
[CUSTOMER][NEUTRAL] OK, total charges are 69928.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] The remit says this product does not have a provider participation network so.
[CUSTOMER][NEUTRAL] I didn't know if it
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Meant that we were nonpar or?
[AGENT][POSITIVE] It's interesting because yeah it shows an outpatient benefit for the calendar year has been met.
[AGENT][NEUTRAL] Is what I'm seeing.
[CUSTOMER][NEUTRAL] Outpatient benefit.
[CUSTOMER][NEUTRAL] For calendar year.
[CUSTOMER][NEUTRAL] Has been met.
[AGENT][NEUTRAL] Yeah, so it looks like the amount paid is showing 2400, which is the outpatient max for the calendar year.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It
[CUSTOMER][NEUTRAL] I will make that note on this and um you said your name was [PII], right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am and if you need a call reference you can use my name and my last initial to my name which is [PII], and then just today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] [PII] alrighty dear, well thank you very much for your help I appreciate it.
[AGENT][POSITIVE] You're welcome, [PII]. Have a good one.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.