AccountId: 011433970860
ContactId: 350e928c-3743-49f1-9e1f-516e7907158c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 296010 ms
Total Talk Time (AGENT): 102503 ms
Total Talk Time (CUSTOMER): 85597 ms
Interruptions: 2
Overall Sentiment: AGENT=0, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/350e928c-3743-49f1-9e1f-516e7907158c_20250523T13:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from office to check on a claim status.
[AGENT][NEUTRAL] I can verify claim status. May I have a policy number?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] It's 1551671.
[AGENT][POSITIVE] I have a good call back number for you.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] It's 877237.
[CUSTOMER][NEUTRAL] 3186. It's a direct.
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. May I have the date of service?
[CUSTOMER][NEUTRAL] Date of service is [PII] for total bill amount $1,213.
[CUSTOMER][NEUTRAL] Even
[AGENT][NEUTRAL] For future reference, you may visit our website at [PII] to check claim status as well. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you have a CPT code that was built on that data service?
[CUSTOMER][NEUTRAL] CPT code is 93306.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, this processed under claim number 3584047.
[AGENT][NEGATIVE] And it looks like the benefit max was met, so no benefits were payable.
[AGENT][NEGATIVE] This claim processed and denied on.
[CUSTOMER][NEUTRAL] Maximum benefits as in access to the right?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Benefit [PII], right?
[AGENT][NEUTRAL] The inpatient benefit max was exhausted. Yes, that is correct.
[CUSTOMER][NEUTRAL] Listen.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] In this claim process.
[CUSTOMER][NEUTRAL] May I know the reason for that?
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] May I know the reason for that, when it was reached and it was reached for dollar value or units exceeded.
[AGENT][NEUTRAL] The inpatient benefit amount allows.
[AGENT][NEUTRAL] 2500, the 2500 max was met prior to this claim being received.
[CUSTOMER][NEUTRAL] Can I get the claim number it was reached?
[AGENT][NEUTRAL] The claim number is
[CUSTOMER][NEUTRAL] To what date of service?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] To which date of service it was reached?
[AGENT][NEUTRAL] It was for the inpatient stay.
[AGENT][NEUTRAL] So it was met prior to this claim being received from a different provider.
[CUSTOMER][POSITIVE] Hey, take care now.
[CUSTOMER][NEUTRAL] And that for also same date of service, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] One more moment.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] What.
[AGENT][NEUTRAL] Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] One more moment.
[CUSTOMER][NEUTRAL] Can I get the receipt it and the processed date?
[AGENT][NEUTRAL] Claim was received on [PII]. Claim processed on [PII].
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] And could you please spell out your name?
[AGENT][NEUTRAL] [PII] Last initial is [PII] along with today's date.
[CUSTOMER][POSITIVE] Perfect. Thank you, [PII]. Thanks for your assistance. Have a wonderful day. Thank you. Bye-bye.
[AGENT][POSITIVE] [PII], you're so welcome and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.