AccountId: 011433970860
ContactId: 2fae6f38-2032-4d78-9df1-57c590c26a24
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256619 ms
Total Talk Time (AGENT): 111321 ms
Total Talk Time (CUSTOMER): 74931 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/2fae6f38-2032-4d78-9df1-57c590c26a24_20250501T14:07_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you for calling
[AGENT][NEUTRAL] This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I was going to go over a claim for a patient.
[AGENT][NEUTRAL] Yeah, I can look at that claim for you. Uh, what was your name, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Uh yes. It, it, oh, sorry.
[CUSTOMER][NEUTRAL] It is D for dog, 41203481.
[AGENT][NEUTRAL] OK, so that's not one of our policy numbers, [PII]. That is through, uh, they're called 90 degree benefit. Um, if you maybe have their social, I could search for them that way. Otherwise I can give you 90 degrees of information and transfer you to them.
[CUSTOMER][NEUTRAL] Uh, well, it says APL and.
[CUSTOMER][NEUTRAL] It's on the website. I have, there's an.
[AGENT][NEUTRAL] Yeah, so those are part of a.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry, they are part of a multi plan, uh, so they may have given you an incorrect card, uh, but 90 degree does offer benefits and they do claims as well, um, so we can definitely see if they have a policy with us, um, but that's just.
[AGENT][NEUTRAL] Would be able to search with that policy number as it's not ours. Do you have their social?
[CUSTOMER][NEUTRAL] There's another policy number on the card.
[AGENT][NEUTRAL] We can try it out.
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] That sounds more like us. Give me just a moment.
[AGENT][NEUTRAL] What was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Yes, that's her policy with us. Uh, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] It's [PII]. Uh bill amount is $550.
[AGENT][NEUTRAL] I'm sorry, that was $550?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] I'm sorry, [PII], what was the name of the provider's office this was with?
[CUSTOMER][NEUTRAL] It's a Nova physician partners.
[AGENT][NEUTRAL] Got it. OK, so we did receive this claim and it looks like we paid a benefit of $75 and with that it did meet their maximum.
[AGENT][NEUTRAL] Uh, for the state of service, as for the other items, uh, vaccines and immunizations are not covered under this policy.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] See.
[CUSTOMER][NEUTRAL] OK. So for the vaccines, um, that would be patient responsibility.
[AGENT][NEUTRAL] We don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] Oh, OK. Is it the same with the non-covered amount?
[AGENT][NEUTRAL] Correct, we don't say what is patient responsibility.
[CUSTOMER][NEUTRAL] For the, um, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you just pay the maximum allowed for um under the plan.
[AGENT][NEUTRAL] Correct, which is in the.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK so it would be $75.
[CUSTOMER][NEUTRAL] OK. All righty. And then um is there a reference number?
[AGENT][NEUTRAL] Sure, it would just be my first name, last initial, and today's date and so my name is spelled [PII] And was there anything else I could help you with [PII]?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] No, that would be all. Thank you for your help. You have a good day.
[AGENT][POSITIVE] Alright, yeah, thanks for calling AP you too bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.