AccountId: 011433970860
ContactId: 29e67e94-54a3-4bc1-8999-d3abf124fbed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 259790 ms
Total Talk Time (AGENT): 79818 ms
Total Talk Time (CUSTOMER): 134714 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/29e67e94-54a3-4bc1-8999-d3abf124fbed_20250602T14:40_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, this is [PII] with Chriscarini Surgery Center, and we received an EOB and I have a question about it if you can assist me with that.
[AGENT][NEUTRAL] Sure, yeah, I can get clarification regarding that EOB. uh [PII], can I get a good callback number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Uh, do you have the policy number?
[CUSTOMER][NEUTRAL] Yes it is.
[CUSTOMER][NEUTRAL] 1451412.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII], uh, [PII].
[AGENT][NEUTRAL] OK perfect thank you for verifying that. uh, do you have the claim number?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh, let me see, no, I do not have the claim number, but I can give you the date of service and the bill charge amount. Would that work?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Sure, yeah, that's perfectly fine.
[CUSTOMER][NEUTRAL] OK, date of service is [PII], and the bill charge is.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $2,544?
[AGENT][NEUTRAL] OK, alrighty, one moment please.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And I'm sorry, what was your name again?
[AGENT][NEUTRAL] It's OK, it's [PII]
[CUSTOMER][POSITIVE] OK thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, what was the, uh, bill, uh, amount after major medical paid, [PII]?
[CUSTOMER][NEUTRAL] Uh, they applied it towards the patient's deductible, and that amount was $847.45.
[AGENT][POSITIVE] Got it. OK, thank you. Let's see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so for this claim, it does look like we paid a benefit of $407.75 and that payment did meet their maximum uh for the benefit amount.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Um, so that's all they had left in their, uh, maximum that they will pay.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, let's see.
[CUSTOMER][NEUTRAL] Is the patient responsible for the remaining amount?
[AGENT][NEUTRAL] So we don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] Oh, OK, so it's up to us if we're gonna charge the patient for the remaining amount?
[AGENT][NEUTRAL] Right, we just don't say one way or the other.
[CUSTOMER][NEUTRAL] OK, um, so that's what they, what was left in the maximum amount, the amount that the patient had left.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Alright, OK.
[CUSTOMER][NEUTRAL] the provider if we want to charge the additional.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, may I have a reference number, please?
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date. Uh, so my last initial is [PII], was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Uh, no, that is it. You just stated that, um, recap is, uh, there's a maximum that they will pay, which is $1000 and what was remaining in that maximum amount was $407.75. Um, it is up to the provider if we want to charge, uh, the additional uh remaining amount.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Correct, uh did you need that claim number?
[CUSTOMER][POSITIVE] I have it. It just, it's just with the, uh, person that's posting, so we do have it though. It's on the ERP, but we're just needing to know. Alright, thank you. You have a great day.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Gotcha. OK.
[AGENT][POSITIVE] No worries.
[AGENT][POSITIVE] Sure. All right. Thank you. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.