AccountId: 011433970860
ContactId: 3f475721-abf9-4a3a-85ac-4257d5ce9d2f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194029 ms
Total Talk Time (AGENT): 75870 ms
Total Talk Time (CUSTOMER): 43836 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/3f475721-abf9-4a3a-85ac-4257d5ce9d2f_20250612T20:06_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh sorry, I had you on mute. Hi, [PII]. My name is [PII]. I need to check on a claim, please.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim and you said your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII]. I have policy number 02473039 ML 8.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Number is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] Data service 31725, total charge 8,299.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Provider is back to surgery and endoscopy center.
[AGENT][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] Alright, so I'm showing the claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 358.
[AGENT][NEUTRAL] 662 8.
[AGENT][NEUTRAL] And on [PII], we paid out on the claim to the provider, a total of $300.
[AGENT][NEUTRAL] And did you need the check information or anything?
[CUSTOMER][NEUTRAL] Yes, please. The $300 is the max benefit.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Cause the patient balance was 2,68936.
[AGENT][NEUTRAL] Yes, the um the outpatient benefit is $300 per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh the check number?
[AGENT][NEUTRAL] Hold on one moment, let me go back to that 1 2nd.
[AGENT][NEUTRAL] The check number is 203.
[AGENT][NEUTRAL] 7840.
[AGENT][NEUTRAL] It was a single check. Did you need any of the, like the clear date or anything?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yeah, I'll take the clear date.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you so much. You have a good day.
[AGENT][NEUTRAL] You're welcome, [PII]. Was there anything else I can help with?
[CUSTOMER][POSITIVE] No, that's all. Thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL bye bye.