AccountId: 011433970860
ContactId: 1f36c7d4-c407-46cd-b594-b492551bca8c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248639 ms
Total Talk Time (AGENT): 80108 ms
Total Talk Time (CUSTOMER): 83956 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/1f36c7d4-c407-46cd-b594-b492551bca8c_20250509T19:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes, hi. This is uh [PII] calling from provider office. I just need a claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 11.
[AGENT][NEUTRAL] OK, do you have the member ID for the patient?
[CUSTOMER][NEUTRAL] Yes, the member ID number is 02593220.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII], and the date of birth is [PII].
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Uh, just a second. The data service is [PII] and the charge amount is $150.
[AGENT][NEUTRAL] OK, looks like we received that claim on.
[AGENT][NEUTRAL] [PII] 18 [PII].
[AGENT][NEUTRAL] It was paid 424, 2025.
[AGENT][NEUTRAL] And we made a payment of $50.
[CUSTOMER][NEUTRAL] Sorry, how much amount you said? It's $50?
[AGENT][NEUTRAL] $50 we paid $50.
[CUSTOMER][NEUTRAL] And what is the allowed amount?
[AGENT][NEUTRAL] Uh there's no allowed amount. It's a supplemental policy.
[CUSTOMER][NEUTRAL] Uh, so what we do, what we need to do with the rest balance? Do we need to transfer that amount or need to adjust off?
[AGENT][NEUTRAL] Um, we can't instruct you on how to bill the patient. We can, we just process the claim according to the policy.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So, uh, I can understand what you said, but, uh, we have to take that action with the rest balance. So is there any something, patient responsibility or something else, rest amount?
[AGENT][NEUTRAL] We don't determine patient responsibility, so we, we paid $50. That's what the policy pays.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] And you don't have any information for the restaurant, OK?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] And you don't have any information for the rest balance?
[AGENT][NEUTRAL] No, we can't, we can't instruct a provider on how to build the patient. It's a supplemental policy. It's not major medical.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] They have that.
[CUSTOMER][NEUTRAL] Do you have the check number and check date for this payment?
[AGENT][NEUTRAL] That number is 204-086-2.
[AGENT][NEUTRAL] Check date [PII].
[CUSTOMER][NEUTRAL] And will you please also provide me the claim number?
[AGENT][NEUTRAL] The claim number is 3593648.
[CUSTOMER][NEUTRAL] OK. And lastly, please provide me the reference number and could you please repeat your good name?
[AGENT][NEUTRAL] The reference number is my name, [PII]. It's [PII]
[AGENT][NEUTRAL] And so it's my name with today's date. So [PII] 5-9-2025.
[CUSTOMER][NEUTRAL] OK. This is the reference number.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. OK, [PII], thank you so much for the information. Have a good day. Bye-bye.
[AGENT][POSITIVE] Thanks for calling APL you as well. Bye-bye.