AccountId: 011433970860
ContactId: 1486833b-930c-4166-8e9f-26d2a73c08b2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 264239 ms
Total Talk Time (AGENT): 100696 ms
Total Talk Time (CUSTOMER): 73718 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/1486833b-930c-4166-8e9f-26d2a73c08b2_20250530T18:28_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I'm calling from South Regional Healthcare. I just wanted to check up on the status.
[AGENT][NEUTRAL] You're checking on a claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] All right, Happy to help. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it's 01841268.
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and his date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what is the date of service?
[CUSTOMER][NEUTRAL] Day of services for [PII].
[AGENT][NEUTRAL] And build them out.
[CUSTOMER][NEUTRAL] $12,567.33.
[AGENT][NEUTRAL] Do you have an amount after primary paid?
[CUSTOMER][NEUTRAL] Yes, that was for.
[CUSTOMER][NEUTRAL] I see the primary left an amount of $2,257.10 as coinsurance.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] So it looks like we did receive this claim, claim was received on [PII].
[AGENT][NEUTRAL] The claim was processed [PII].
[AGENT][NEUTRAL] There was a benefit payment sent in the amount of $1,934.60.
[AGENT][NEUTRAL] This is the maximum benefit for the date of service.
[CUSTOMER][NEUTRAL] And what about the remaining amount of $322.50? Was that the contractual adjustment of the provider's discount?
[AGENT][NEUTRAL] Uh, the 193,460 was the max benefit payable for the date of service. Anything remaining, it's up to the provider facility to decide if that's patient responsibility. We do not advise on that.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Alright, well, how was the payment made? Was it through check or an EFT?
[AGENT][NEUTRAL] Single check.
[CUSTOMER][NEUTRAL] And what's the check number?
[AGENT][NEUTRAL] 1865144.
[CUSTOMER][NEUTRAL] And when was this issued?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Issued on [PII].
[CUSTOMER][NEUTRAL] And do you have the cash date for this?
[AGENT][NEUTRAL] I do not. I do show it's been cached.
[CUSTOMER][NEUTRAL] OK, um, well, would you be able to fax me the EOB for this?
[AGENT][NEUTRAL] What's the fax number?
[CUSTOMER][NEUTRAL] It's 615.
[CUSTOMER][NEUTRAL] 538.
[CUSTOMER][NEUTRAL] 0817.
[CUSTOMER][NEUTRAL] And I'd also like to know the claim number, please.
[AGENT][NEUTRAL] Claim number is gonna be 348.
[AGENT][NEUTRAL] 553 1.
[AGENT][NEUTRAL] Should we mark attention to anybody on the facts?
[CUSTOMER][NEUTRAL] Well, I'd like it to my name.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And [PII], can you lastly help me with the call reference number?
[AGENT][NEUTRAL] Call reference is my name with today's date. My name again is [PII], that's [PII]
[AGENT][NEUTRAL] The initial to my last name is [PII] and then today's date.
[CUSTOMER][POSITIVE] Alright, thank you so much. Well then that is it from my side.
[AGENT][POSITIVE] You're welcome bye bye.