AccountId: 011433970860
ContactId: 4b4975ed-62f3-48ba-98ac-aec4a1d23723
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 274640 ms
Total Talk Time (AGENT): 100656 ms
Total Talk Time (CUSTOMER): 89869 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/4b4975ed-62f3-48ba-98ac-aec4a1d23723_20250310T21:15_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is. How may I assist you?
[CUSTOMER][NEUTRAL] Um, hi, my name is [PII]. I'm calling for the provider's office taking on a claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, and I'm sorry, can you repeat your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK. Thank you, Mr. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah one moment.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] The patient's policy number is D as in Delta 43729246.
[AGENT][NEUTRAL] Do you see a policy certificate number? It's gonna start with the 0 followed by 7 digits. That's gonna be our number, Mr. [PII].
[CUSTOMER][NEUTRAL] OK, uh, do you know?
[CUSTOMER][NEUTRAL] Uh who's the insurance first member?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Because we have received this year for this patient, the patient name [PII].
[AGENT][NEUTRAL] What's the EOB number? What's the claim number?
[CUSTOMER][NEUTRAL] And the contact number.
[CUSTOMER][NEUTRAL] Of the claim number, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Claim number is 338-717-6.
[AGENT][NEUTRAL] 3387.
[CUSTOMER][NEUTRAL] 338-717-6
[AGENT][NEUTRAL] OK, let me try that. One moment.
[AGENT][NEUTRAL] It's gonna be a minute. I'm waiting on that EOB.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] patient name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is uh [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Mhm. The date of services number you are number [PII].
[CUSTOMER][NEUTRAL] And the total bill amount of $931 even.
[AGENT][NEUTRAL] OK, thank you. And this was for an ER visit?
[CUSTOMER][NEUTRAL] This is for
[CUSTOMER][NEUTRAL] Yeah, for the 992826.
[AGENT][NEUTRAL] OK. All right, so it looks like we processed the claim on [PII] and we pay the maximum benefit for an ER visit. Based on the policy benefits, $75 is the maximum payable for an ER visit under this plan.
[CUSTOMER][NEUTRAL] OK, what is the plan name?
[AGENT][NEUTRAL] This is a limited hospital indemnity policy.
[CUSTOMER][NEUTRAL] I'm sorry, what did you say?
[AGENT][NEUTRAL] Limited
[AGENT][NEUTRAL] Hospital
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Indemnity policy.
[CUSTOMER][NEUTRAL] OK, so what are the balances will be a write off or the patient responsibility?
[AGENT][NEUTRAL] It's gonna be up to the provider's discretion. We don't have any contractual involvement on the remaining of the claim. We don't know if they have any other policies out there.
[CUSTOMER][POSITIVE] OK, thank you and.
[AGENT][NEUTRAL] This is just a limited policy. Mhm.
[CUSTOMER][NEUTRAL] OK, thank you and your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] And the reference number for our call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's thing.
[CUSTOMER][POSITIVE] OK, thank you sir have a wonderful day.
[AGENT][POSITIVE] You're welcome. You as well thank you for calling APR. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye.
[AGENT][NEUTRAL] OK