AccountId: 011433970860
ContactId: 4ebf02d8-537d-466c-a238-4ccb8653a175
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 624020 ms
Total Talk Time (AGENT): 120130 ms
Total Talk Time (CUSTOMER): 120087 ms
Interruptions: 4
Overall Sentiment: AGENT=0.8, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/4ebf02d8-537d-466c-a238-4ccb8653a175_20250522T21:24_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, hi, my name is [PII] calling you from Mercy Hospital. I'm calling you to information my claim. And you said your name was?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, so,
[AGENT][NEUTRAL] And, and how do you spell your name?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII]. That's spelled [PII]
[CUSTOMER][NEUTRAL] Last name [PII].
[AGENT][NEUTRAL] OK. And may I have a callback number just in case we get disconnected, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah, callback number [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] 249-725-4
[AGENT][NEUTRAL] One moment, let me pull this information.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have, um, you said you need benefits?
[CUSTOMER][NEUTRAL] A claim status no no claim status.
[AGENT][NEUTRAL] OK. What is the date of service?
[CUSTOMER][NEUTRAL] [PII] will amount $4,177.26.
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][NEUTRAL] uh.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And for future you can check claim status online through the website [PII].
[AGENT][NEUTRAL] And that's just optional and bear with me let me pull this EV.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You're waiting on the EB to pull up, OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like we processed this claim on [PII] and we send a benefit amount of $250 to the provider.
[AGENT][NEUTRAL] 250 is the maximum payable for that service under this policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So with that benefit, they assess the benefit. Mhm.
[CUSTOMER][POSITIVE] Maximum payable for this.
[CUSTOMER][NEGATIVE] They exhausted the benefits.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] With the payment of this claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. What are the benefits they exhausted, like are the units, visits, or what are they?
[AGENT][NEUTRAL] Diagnostic testing benefit, diagnostic testing benefit.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Diagnostic.
[CUSTOMER][NEUTRAL] Just one moment please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What was dynastic or dynastic? What was that?
[AGENT][NEUTRAL] diagnostics, diagnostic testing benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] OK, so do you have that UP that shows the no member um exhausted their benefits?
[AGENT][NEUTRAL] It's the same one we send with the check.
[CUSTOMER][NEGATIVE] Because we've received an incomplete information in here.
[CUSTOMER][NEUTRAL] Uh, there is, that is no we received with the incomplete information. Nothing is showing on the uh you know, UOB. We can only see the payment information which is $250.
[AGENT][NEUTRAL] You don't have the back part of the EOB?
[CUSTOMER][NEUTRAL] Other than that, there is nothing mentioned on the UOP.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] You don't have the 2nd page. OK. What is the fax number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] [PII] what attention?
[CUSTOMER][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] No, you can use my name as an attention. That is [PII] [PII].
[AGENT][NEUTRAL] OK, do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me. OK, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, that's all for today. And what's the call reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in the state.
[CUSTOMER][POSITIVE] OK, [PII]. Thank you so very much. Have a nice day. Bye-bye.
[AGENT][POSITIVE] Welcome. You as well. Thank you for calling APL. Bye bye.
[CUSTOMER][NEUTRAL] Yeah bye.