AccountId: 011433970860
ContactId: 36e4861e-1868-4858-abe8-74f209afec1d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173240 ms
Total Talk Time (AGENT): 48875 ms
Total Talk Time (CUSTOMER): 71884 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/36e4861e-1868-4858-abe8-74f209afec1d_20250325T14:56_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I am calling from Taova [PII]. Uh, I have just got a question about a remit that we received and um hoping you can help me out.
[AGENT][NEUTRAL] OK. And you're with the group, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And is this for an invoice?
[CUSTOMER][NEUTRAL] Yeah, it's uh it looks like it's a an EOB and explanation of benefits.
[AGENT][NEUTRAL] Oh, OK. Let me see.
[AGENT][NEUTRAL] Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Policy number is 02156805.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], uh sorry, [PII].
[AGENT][NEUTRAL] Hey [PII], can I get a good callback number from you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you wanted claim status. Do you have the claim number for that on that EOB?
[CUSTOMER][NEUTRAL] Yes, that claim number is 3561791.
[AGENT][NEUTRAL] OK, and what was your question on the claim?
[CUSTOMER][NEUTRAL] Well, it shows that there's a payment of $50 but it doesn't show if the rest was adjusted or if the rest is patient responsibility. It doesn't really give us any kind of information so we don't know if we need to build the patient for the remainder.
[CUSTOMER][NEUTRAL] Uh, or what's going on?
[AGENT][NEUTRAL] Um, so this is just like a supplemental policy. It's a hospital indemnity plan, so we don't determine patient responsibility. We just pay out according to what the plan covers, and $50 was the benefit for the claim that was submitted.
[CUSTOMER][NEUTRAL] OK, so you're a supplemental policy, you're a secondary policy?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, so they just have a $50 per day benefit, is that what it is that what it is?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] All right, perfect. Do you have a reference number for the call?
[AGENT][NEUTRAL] It'll just be my first name, last initial, it's [PII], and then [PII], today's date. Is there anything else I can help with today?
[CUSTOMER][POSITIVE] No, that's gonna be it thank you so much.
[AGENT][POSITIVE] Thank you for calling APL have a great afternoon.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Mm