AccountId: 011433970860
ContactId: 18543e2b-12b1-42c4-a8e2-6e6163690129
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 178570 ms
Total Talk Time (AGENT): 61848 ms
Total Talk Time (CUSTOMER): 60042 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/18543e2b-12b1-42c4-a8e2-6e6163690129_20250115T15:03_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes [PII] I am calling to get um.
[CUSTOMER][NEUTRAL] Claim status please on a patient.
[AGENT][NEUTRAL] OK. May I ask who's calling?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, ma'am. It's 764-310.
[AGENT][NEUTRAL] Hold on one moment please.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And her date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were just needing claim status?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I can look that up for you. What date of service?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] Billed amount is $140.
[AGENT][NEUTRAL] And what was that procedure code?
[CUSTOMER][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] G 0422
[AGENT][NEUTRAL] OK, we did get that claim in. It was denied for the maximum benefit for the outpatient sickness rider has been exhausted for the calendar year.
[CUSTOMER][NEUTRAL] OK, so is that patients responsibility?
[AGENT][NEUTRAL] Yes, ma'am. Whatever is leftover will be their responsibility.
[CUSTOMER][NEUTRAL] OK, because the EOB doesn't state that um the copy that we have.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] None of our EOBs have that on there because this is just uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's not a major medical policy.
[CUSTOMER][NEUTRAL] OK, and what was your name again?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII], I was gonna say [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, do you have a uh call reference number?
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name and today's date.
[CUSTOMER][NEUTRAL] OK, I will do that and I'll make a note that this is patients responsibility per Ms [PII].
[AGENT][NEUTRAL] OK. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] Thank you, [PII], for calling APO. You have a good day. You too. Bye-bye.
[CUSTOMER][POSITIVE] You have a you have a good day.
[CUSTOMER][NEUTRAL] OK bye bye.