AccountId: 011433970860
ContactId: 1626a5a9-7851-45e1-9fed-b00c01654146
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 341420 ms
Total Talk Time (AGENT): 156271 ms
Total Talk Time (CUSTOMER): 99909 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/1626a5a9-7851-45e1-9fed-b00c01654146_20250106T20:39_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], my name is [PII]. So should I give you my information?
[AGENT][NEUTRAL] You said your name is [PII]. What was the last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, Ms. [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Policy number is 02443376.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][POSITIVE] And I have you pulled up here, and how may I assist you today?
[CUSTOMER][NEUTRAL] I was calling because uh I go to the Cleveland clinic and they say I have a balance of what is this? Let me see.
[CUSTOMER][NEUTRAL] 5153, which is my co-pay.
[CUSTOMER][NEUTRAL] Uh, this was for a visit, uh, [PII].
[AGENT][NEUTRAL] OK, and I just need you to verify your date of birth, your mailing and email address on file, and then I can get into the policy and take a look for you.
[CUSTOMER][NEUTRAL] OK. Uh, email pre [PII].
[CUSTOMER][NEUTRAL] What else did you say?
[AGENT][NEUTRAL] Your date of birth and your home address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] My home address is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So you're wanting to know for the [PII], if there's a claim on file?
[CUSTOMER][NEUTRAL] Uh, yeah, I called before and they told me, yeah, they, they were gonna pay the co-payment, they got to pay to the clean and clean for the doctor was uh [PII].
[AGENT][NEUTRAL] Let me take a look at your, hold on one moment. I'm looking up the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Max.
[AGENT][NEUTRAL] And Ms. [PII], do you mind if I place you on just a brief hold while I take a look at this?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Wait a second.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So who's deductible is the question like what?
[AGENT][NEUTRAL] Outbound, I mean outbound, outpatient must have a deductible, but I don't see that anywhere here.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Right there. Oh, I see it now. Certificate deductible max amount is $1500. OK, so that's what happened.
[AGENT][NEUTRAL] OK, hello Miss. [PII].
[CUSTOMER][NEUTRAL] Mhm, yeah.
[AGENT][POSITIVE] Thank you so much for holding. So the $61.53 your policy has a deductible of $1500. So that $61.53 was applied to your deductible to your policy.
[CUSTOMER][NEUTRAL] OK, so you guys don't pay for that?
[AGENT][NEUTRAL] Don't pay for your deductible?
[CUSTOMER][NEUTRAL] Uh, for which, uh, so this is my responsibility to pay for that?
[AGENT][NEUTRAL] Uh, we don't determine patient responsibility here, but if you've received the bill after the claim has come out, um, and it's showing that $6153 then that bill is saying that you're responsible for that amount, but for what was processed, it was, it went towards your $1500 so we can start paying out on claims.
[CUSTOMER][NEGATIVE] I really don't understand what you're saying.
[AGENT][NEUTRAL] So a deductible or a co-pay is what is is it's almost like a, I don't want to say a bill, but a deductible is something that you have to pay before your insurance company pays out on claims. So
[CUSTOMER][NEUTRAL] It was built
[CUSTOMER][NEUTRAL] It starts paying, OK, so my co-pay was, yeah, I know that it's $10 so the other $51 is the deductible that's what you say?
[AGENT][NEUTRAL] So this
[AGENT][NEUTRAL] Your deductible for your policy here with APL is $1500. So that's $61.53 and there's a few other claims, it's going towards your deductible and once that's paid, then your claims can be paid.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, so then I have to pay for this.
[AGENT][NEUTRAL] Yes, if you've received the bill for that 6153, yes, ma'am.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that will be all. Thank you.
[AGENT][POSITIVE] You're welcome. Well, thanks for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] You too. Bye-bye.