AccountId: 011433970860
ContactId: 47fdb136-bab8-4749-bb16-02676576ca38
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284660 ms
Total Talk Time (AGENT): 101050 ms
Total Talk Time (CUSTOMER): 70164 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/2025/02/13/47fdb136-bab8-4749-bb16-02676576ca38_20250213T18:00_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so, this is [PII], and I'm calling from Peachtree Immediate Care and I have a question on a claim.
[AGENT][NEUTRAL] OK, um, sure, I can assist you with claims. Um, may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Um [PII].
[AGENT][NEUTRAL] OK. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Um, policy number is 02556944.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] And I'm sorry, can you repeat your name one more time?
[CUSTOMER][NEUTRAL] Um, first name is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Alright, and may I have the name and date of birth of the patient, Miss [PII]?
[CUSTOMER][NEUTRAL] It's um [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] All right. And what is the day of service and the amount of the claim?
[CUSTOMER][NEUTRAL] I have uh [PII] build amount $655.02.
[AGENT][NEUTRAL] OK, let's see if I have that claim. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me pull this ELB one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Ms. [PII], I just need to let you know that for future you can check your claim status online through our website at [PII] and that's just optional.
[AGENT][NEUTRAL] And I'm still waiting.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] I'm so sorry it's taking forever to pull up. I'm sorry.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK, here it is, um, we process the claim on [PII] and we send a benefit amount of $50 for the code 99204.
[AGENT][NEUTRAL] And that is the maximum benefit for the date of service.
[CUSTOMER][NEUTRAL] OK, um, so it's the $50 now, is the full amount, uh, patient responsibility then?
[AGENT][NEUTRAL] It's up to the provider's discretion. Uh, we don't have any contractual involvement on the remaining of the claim. This is just a limited policy. We don't know if he has any other policy out there, any other major medical or any other policies out there.
[CUSTOMER][NEUTRAL] OK, sir.
[CUSTOMER][NEUTRAL] OK, so this is just a limited policy that pays a max of $50.
[AGENT][NEUTRAL] Yes, this is an indemnity policy which it pays a flat amount of $50 right.
[CUSTOMER][NEUTRAL] OK, all right, um, well, that's all, all that I needed and, uh, so is there a reference number to the call?
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will, Miss [PII], do you need the spelling of my name or any other information?
[CUSTOMER][POSITIVE] Um, no, that is all. Um, I appreciate your time. Thank you so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling ATL. Have a good day, Mr. [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you. You're welcome. Bye.