AccountId: 011433970860
ContactId: 37d28e5d-d18f-42c9-aa99-4924c7e2f651
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285540 ms
Total Talk Time (AGENT): 97409 ms
Total Talk Time (CUSTOMER): 106502 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/37d28e5d-d18f-42c9-aa99-4924c7e2f651_20250312T13:12_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]. Good morning. My name is [PII]. I'm a provider. Good morning. I was calling for a claim status. Hi.
[AGENT][POSITIVE] Good morning.
[AGENT][NEUTRAL] Hi [PII].
[AGENT][NEUTRAL] I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Thank you. The policy number is 01996823.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][POSITIVE] Mhm thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] This is for um I'm gonna go pick up [PII]. Date of birth [PII].
[AGENT][POSITIVE] All right, thank you for that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you stated that you're checking the claim status?
[CUSTOMER][NEUTRAL] Yes, for data service [PII], the total bill amount for the claim was $16,425.75.
[AGENT][NEUTRAL] OK, so is this a facility charge?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm showing that a payment of 3916 was paid and it looks like that was the remaining benefit. Yeah, with this payment of this check, the policy maximum for this benefit has been met. That was the amount available for 2024. That was what was left and did you receive the check and you were just questioning the payment?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, I was, and I don't have the claim number or the, I just needed the claim information. When was the claim received?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The received date [PII], processed on [PII].
[AGENT][NEUTRAL] And the claim number is 354.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 0052.
[AGENT][NEUTRAL] And check number 2017792.
[CUSTOMER][NEUTRAL] OK, and you guys did process as secondary, correct?
[AGENT][NEUTRAL] We did.
[CUSTOMER][NEUTRAL] OK, so you did get the primary EOB.
[CUSTOMER][NEUTRAL] Oh, OK, so the service is max. So the remaining balance is patient liability?
[AGENT][NEUTRAL] We don't determine. I see what they apply the 823 60, but of that amount we only their benefit, the remaining benefit at that time was just the $39.16.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK. And uh do you have a copy of that?
[AGENT][NEUTRAL] The explanation was mailed along with the check and it's, it can be downloaded from our our service center um at [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh, [PII]. Yes ma'am.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Alright, and that claim number was 3540052, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. I keep writing down stuff and I'm like, OK, which one was that? And it's still early.
[CUSTOMER][NEUTRAL] Oh my goodness, it's still, it's still early. All right. Is there a reference number for the call today?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII].
[AGENT][NEUTRAL] [PII] and first initial and last name is [PII]. Anything else, Ms. [PII]?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] All right, thank you. That's all I needed. Thank you so much. I really appreciate your help today.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You too bye bye