AccountId: 011433970860
ContactId: 144992f2-85db-41a2-a287-662388ac8157
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 307390 ms
Total Talk Time (AGENT): 100687 ms
Total Talk Time (CUSTOMER): 83728 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/144992f2-85db-41a2-a287-662388ac8157_20250418T17:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, hi, this is um [PII]. I'm looking for the claim status.
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] And [PII], what's the policy number?
[CUSTOMER][NEUTRAL] Uh, policy number is 02443351.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And you said you're checking a claim status?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Patient's first name is uh [PII], and the last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information. And what's the date of service of the claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] In the amount?
[CUSTOMER][NEUTRAL] $2750 even.
[AGENT][NEUTRAL] The name of the provider?
[CUSTOMER][NEUTRAL] Um, Elite Imaging LLC.
[AGENT][NEUTRAL] And what's the procedure code on the claim?
[CUSTOMER][NEUTRAL] 721-97.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEGATIVE] Looks like we received the claim twice and we denied it each time citing that all payable benefits were applied towards the policy deductible, um, do you want both claim numbers?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Mm, A plus your deductible, you said, correct? So how much is the deductible amount?
[AGENT][NEUTRAL] I'm sorry, what was the question?
[CUSTOMER][NEUTRAL] You said the claim was applied to a deductible, correct?
[AGENT][NEUTRAL] Correct. There's a deductible under this policy that they have to satisfy.
[AGENT][NEUTRAL] So I'm showing.
[CUSTOMER][NEUTRAL] OK. How much is that?
[AGENT][NEUTRAL] How much was applied or?
[AGENT][NEUTRAL] What's the calendar year deductible?
[CUSTOMER][NEUTRAL] How much it was applied to?
[AGENT][NEUTRAL] $50.
[CUSTOMER][NEUTRAL] $50. OK. And how much of uh remaining?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] The annual remaining amount of deductible.
[AGENT][NEUTRAL] OK, the annual deductible amount, one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] We'll be.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It's $1500 per calendar year per person.
[CUSTOMER][NEUTRAL] How much?
[AGENT][NEUTRAL] $1500.
[AGENT][NEUTRAL] Per calendar year, per person.
[CUSTOMER][NEUTRAL] OK, and how much the patient me it till late?
[AGENT][NEUTRAL] 150.
[AGENT][NEUTRAL] 150.
[CUSTOMER][NEUTRAL] 150.
[AGENT][NEUTRAL] 150.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, I got that. There's a claim number.
[AGENT][NEUTRAL] OK. Any
[AGENT][NEUTRAL] The claim number is 358-4800 and did you have any other questions, [PII] I could help out with today?
[CUSTOMER][NEUTRAL] Uh, just the deductible EUB. Can you fax on my fax number?
[AGENT][NEUTRAL] It was already mailed to the address that's on your claim on [PII], so you can download it now from our online service center. Uh, that address is secured. [PII] and I can help you set up the account if you if you would like.
[CUSTOMER][NEUTRAL] Um, no, just received it at the process date of this claim.
[AGENT][NEUTRAL] The claim date received is [PII], processed [PII].
[AGENT][NEUTRAL] ELB was mailed [PII].
[CUSTOMER][NEUTRAL] OK. [PII].
[CUSTOMER][POSITIVE] Perfect. And this is the reference number.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, double call reference number.
[AGENT][NEUTRAL] My name in today's date, [PII].
[AGENT][NEUTRAL] O N Y A. First initial and last name is [PII]. And anything else, [PII]?
[CUSTOMER][NEUTRAL] No, that's all we have for today.
[AGENT][POSITIVE] Alrighty thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Have a good day too. Bye.