AccountId: 011433970860
ContactId: 3042ad3d-b476-4e00-aa33-69c20ca0511a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 315489 ms
Total Talk Time (AGENT): 114642 ms
Total Talk Time (CUSTOMER): 85820 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/3042ad3d-b476-4e00-aa33-69c20ca0511a_20250128T20:12_UTC.wav
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[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 um regarding a claim.
[AGENT][NEUTRAL] OK [PII], I can help you with the claim. Uh, can I please get your callback number just in case your call is disconnected?
[CUSTOMER][NEUTRAL] [PII]. Excuse me, got the hiccups.
[AGENT][NEUTRAL] That's fine, Ms. [PII]. OK, is the claim for yourself or are you with the facility?
[CUSTOMER][NEUTRAL] Facility.
[AGENT][NEUTRAL] OK, what is the name of your facility, please?
[CUSTOMER][NEUTRAL] Baptist Health Medical Group.
[AGENT][NEUTRAL] OK, and then what is the patient's name?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] OK, what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] And then her policy number, please?
[CUSTOMER][NEUTRAL] Uh, that is 228-8808.
[AGENT][NEUTRAL] OK, let me pull that in real quick.
[AGENT][NEUTRAL] And then what is the date of service?
[CUSTOMER][NEUTRAL] Uh, data service is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] Uh, $193.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Alright, Ms. [PII], I'm gonna put you on a brief hold while I look up this claim for you and I'll be back in just a sec.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi Ms. [PII], this is [PII]. So looking on data service of [PII], I am not finding a claim on file for the dollar amount that you've given me.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Uh, for $243.
[AGENT][NEUTRAL] Yes, I have that one.
[CUSTOMER][POSITIVE] OK, what did I say at first? I'm so sorry.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] You said 193?
[CUSTOMER][NEUTRAL] Oh my [PII], I'm looking at the balance. Oh my [PII], I'm telling you it's been a long day today.
[AGENT][POSITIVE] Bless your heart.
[AGENT][POSITIVE] That's OK. I got you girl.
[CUSTOMER][POSITIVE] I'm ready for a nap.
[AGENT][NEUTRAL] OK, so that claim was paid $50 with check number 2021667.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look up the check number real quick.
[CUSTOMER][NEUTRAL] I do have the I do show the $50 payment but there's a remainder of $19393 so is is there a contractual?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look and see what the remarks say.
[AGENT][NEUTRAL] It says with this check the maximum benefit payable for this day of service was met.
[CUSTOMER][NEUTRAL] OK, so max benefit was $50.
[AGENT][POSITIVE] So the, the benefit was maxed out. Yes, ma'am.
[CUSTOMER][NEUTRAL] What kind of plan is this a limited benefit plan?
[AGENT][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] OK, and do they pay out like $50 per office visit?
[AGENT][NEUTRAL] Let me look and see.
[CUSTOMER][NEUTRAL] So it sounds like it is.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yes, um,
[AGENT][NEUTRAL] This is just to verify her coverage is not a guarantee of payment, $50 for office visits and she gets $4 a year.
[CUSTOMER][NEUTRAL] OK, alright, I just have to notate that. Alright, what's the claim number?
[AGENT][NEUTRAL] The claim number is 3547453.
[CUSTOMER][NEUTRAL] OK, and uh [PII], what is your reference number?
[AGENT][NEUTRAL] You can use my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much you have a great day.
[AGENT][POSITIVE] You too, Ms. [PII]. You have a good one. Thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Uh huh bye bye.