AccountId: 011433970860
ContactId: 1cf191b4-4016-458f-a55b-0eb8fbce771a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 306500 ms
Total Talk Time (AGENT): 85289 ms
Total Talk Time (CUSTOMER): 84664 ms
Interruptions: 1
Overall Sentiment: AGENT=2, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/1cf191b4-4016-458f-a55b-0eb8fbce771a_20250421T16:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] from provider service.
[AGENT][NEUTRAL] How may I assist you, [PII]?
[CUSTOMER][NEUTRAL] Um, may I just check, uh, time status for my member?
[AGENT][NEUTRAL] May I please have a callback number and then the policy number?
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Sure, the callback number it's uh
[CUSTOMER][NEUTRAL] [PII] and it's a direct line?
[CUSTOMER][NEUTRAL] The policy number is 258-532-5.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Sure. The patient name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth, it's uh [PII].
[AGENT][POSITIVE] And thank you so much, [PII], for verifying the policy. You're calling in for status. May I please have the date of service and total bill?
[CUSTOMER][NEUTRAL] Sure. The date of service is [PII] with the bill amount of $629 even.
[AGENT][POSITIVE] Thank you, and you can also check claim status via our secured portal that is [PII] and I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] You can
[CUSTOMER][POSITIVE] Yeah, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And for that claim it does show that we received it on [PII]. It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 358-0766.
[AGENT][NEUTRAL] It shows a process and made a payment in the amount of $50. Once that claim was paid, that was the maximum amount per day that could be paid out for this member. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Once they
[CUSTOMER][NEUTRAL] There
[CUSTOMER][NEUTRAL] Yeah, it's uh just for the, so, so you'll not make any payment for the code 87502 and 87811.
[AGENT][NEGATIVE] It's those two denied that the maximum per calendar day had been met.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Um, could you please give me a moment?
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah, hello, ma'am.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, so, uh, here I see that the codes uh been billed only once on the day.
[CUSTOMER][NEUTRAL] The code 87502 and 87811 has been billed only once. So have you
[CUSTOMER][NEUTRAL] Uh, to to that maximum benefit paid uh for that code.
[AGENT][NEUTRAL] As I'm stating for that date of service, the per calendar day max had been met once we paid that $50.
[CUSTOMER][NEUTRAL] As I'm stating for that date.
[CUSTOMER][NEUTRAL] OK, so no, no other payments will be made.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] OK. And uh can I get your name, please?
[AGENT][NEUTRAL] Yes, for the reference, it would be my first name [PII], last initial of [PII] and today's date.
[CUSTOMER][NEUTRAL] With
[CUSTOMER][POSITIVE] Got it. So thank you for helping me.
[AGENT][POSITIVE] You're welcome, and I do wanna thank you for calling American Public Life, [PII]. You have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. Have a great day. Bye bye.
[AGENT][POSITIVE] Thank you, bye.