AccountId: 011433970860
ContactId: 1f2f9664-5c3c-4d36-987e-7b8c4706a550
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173559 ms
Total Talk Time (AGENT): 48601 ms
Total Talk Time (CUSTOMER): 73775 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/1f2f9664-5c3c-4d36-987e-7b8c4706a550_20250612T13:57_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling from a provider's office regarding a patient's claim.
[AGENT][NEUTRAL] OK, I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] And can I get your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], do you have the policy number for that patient?
[CUSTOMER][NEUTRAL] Um, yes, I think I, give me one second cause
[CUSTOMER][NEUTRAL] They didn't provide an insurance card. I hope this is it. So it's going to be 02584421.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Uh, looks like we've got this policy terminated 3-16-25.
[CUSTOMER][NEUTRAL] So uh yeah I'm calling because I have a question regarding a claim.
[AGENT][NEUTRAL] Oh, I'm sorry, um, what was the date of service? Sorry about that.
[CUSTOMER][NEUTRAL] That that's OK and the date of service is [PII].
[AGENT][NEUTRAL] OK. Uh, looks like.
[AGENT][NEUTRAL] And we made a payment of 150.
[CUSTOMER][NEUTRAL] Yes, um, yes, because yesterday I had called and I forgot to confirm because the previous representative informed me that the the max benefits were already paid, so I wanted to confirm if the remaining balance of the of the balance is um is the patient portion or it's just 150.
[AGENT][NEUTRAL] Um, we just paid the max 150, um, since this is a supplemental policy, we can't determine patient responsibility. We just process the claim according to the policy.
[CUSTOMER][NEUTRAL] So you, so you guys didn't leave the rest of the patient responsibility, is that correct? Because the EOB that we have here doesn't really specify, so that's why we needed to confirm.
[AGENT][NEUTRAL] Yeah, we don't, so since it's supplemental, we don't specify patient responsibility because it's a supplemental policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] OK. Thanks for calling
[CUSTOMER][NEUTRAL] And do, is there a reference number for this?
[AGENT][NEUTRAL] Yes, it's my name [PII] and first initial to last name [PII] and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect thank you I appreciate it.
[AGENT][POSITIVE] Thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.