AccountId: 011433970860
ContactId: 4928e004-dfa5-4df4-ae13-21a128600c58
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 198289 ms
Total Talk Time (AGENT): 88207 ms
Total Talk Time (CUSTOMER): 92589 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/4928e004-dfa5-4df4-ae13-21a128600c58_20250102T16:33_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] with Parkview Physicians. How are you?
[AGENT][POSITIVE] Doing well, [PII]. Thank you for asking. How are you doing in [PII]?
[CUSTOMER][POSITIVE] Yeah right, I'm doing well. Um, I spelled because there's numerous ways to spell [PII], [PII]
[AGENT][POSITIVE] Bingo, you are good. Starting off the [PII], right.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] With that being said, I have a neighbor that it's spelled the exact same way, but it's pronounced [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Never heard that pronunciation. I've heard [PII], everything else.
[CUSTOMER][NEUTRAL] Uh huh and
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEGATIVE] Yeah, no, no.
[CUSTOMER][NEUTRAL] It's weird
[AGENT][NEUTRAL] [PII]. Hm, that's a new one.
[CUSTOMER][NEUTRAL] Yeah, you know.
[CUSTOMER][NEUTRAL] Yeah, a little bit
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hey, I have a claim that I'm calling about. It paid $75 but then.
[CUSTOMER][NEUTRAL] I'm the EOBs are a little generic so I'm not too sure what they did with the other code and what they did with the remaining on.
[CUSTOMER][NEUTRAL] The other one, I just need to get a little bit more information please and thank you.
[AGENT][POSITIVE] It, it would be my pleasure, [PII]. And what is a good callback number?
[CUSTOMER][NEUTRAL] Direct line no extension [PII].
[AGENT][NEUTRAL] Thank you, [PII] and what is the policy I mean the claim number, do you have that available?
[CUSTOMER][NEUTRAL] That is 3543582.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] And date of birth.
[CUSTOMER][NEUTRAL] Oh sorry, date of birth [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] So with this policy, it is a per calendar day benefit.
[AGENT][NEUTRAL] And the maximum we pay per day is $75 so that was paid on the CPT 99213.
[AGENT][NEUTRAL] And then the 87426 was denied the maximum met for that data service.
[CUSTOMER][NEUTRAL] So was the remaining.
[CUSTOMER][NEUTRAL] $167.14 then applied towards the patient.
[AGENT][NEUTRAL] So this is a limited indemnity policy. There's no repricing on the claim and
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It any patient responsibility would be determined by the provider.
[CUSTOMER][NEUTRAL] OK, so the remaining is applied towards the patient responsibility, however, we have.
[CUSTOMER][NEUTRAL] To say so on if we're going to um charge them or not.
[AGENT][NEUTRAL] Bill the patient. That's right. The provider provider decides if there's a write-off or uh bill the patient because we're not major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then what is our call reference number please?
[AGENT][NEUTRAL] It's gonna be my name in today's date.
[CUSTOMER][POSITIVE] Got it thank you so much I appreciate your help, [PII].
[AGENT][POSITIVE] It's been such a pleasure to assist you, [PII]. Thank you for calling APL and I hope you have a wonderful day and happy New Year. Mhm.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] You too, thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.