AccountId: 011433970860
ContactId: 28a87d9b-194e-41e8-bbcb-379a27c3cdb6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 325000 ms
Total Talk Time (AGENT): 90929 ms
Total Talk Time (CUSTOMER): 57080 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/28a87d9b-194e-41e8-bbcb-379a27c3cdb6_20250404T17:16_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I'm calling from North Memorial Health. I have a question on a claim.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with the claim.
[AGENT][NEUTRAL] Can I please get your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, policy number is 02434160. Patient's name is [PII] [PII].
[AGENT][NEUTRAL] OK, let me pull that policy up for us real quick.
[AGENT][NEUTRAL] OK and then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] 72024 to 722 2024. And the charged amount is $27,218.74.
[AGENT][NEUTRAL] OK and you said you were calling from North Memorial.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes ma'am, and you said you were calling from North Memorial Health?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim and I'll be right back.
[CUSTOMER][POSITIVE] Alright, thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm. 27,000.
[AGENT][NEUTRAL] It's gonna be that one.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Alright, thank you very much for holding for me. So I do have the claim pulled up and um there are some remarks on the claim and the claim was paid $650 with check number 2011596.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] After that benefit amount was paid, the calendar maximum for the benefit was exhausted with the payment of that claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And also.
[AGENT][NEUTRAL] The calendar year maximum for the diagnostic services was already maxed out before the claim came in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And can I please get a call reference number?
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All right, got it. Thank you so much for your help.
[AGENT][POSITIVE] You're very welcome. Is there anything else I can help you with, Miss [PII], before we go?
[CUSTOMER][POSITIVE] Uh, no, nothing else. Thank you.
[AGENT][POSITIVE] You're welcome have a wonderful weekend and thank you for calling APL.
[AGENT][NEUTRAL] Bye-bye, ma'am.
[CUSTOMER][POSITIVE] All right. Have a wonderful weekend. Bye.
[AGENT][POSITIVE] Thank you. Bye