AccountId: 011433970860
ContactId: 542c6cee-76e3-43af-b31f-debf2e3e9784
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 238740 ms
Total Talk Time (AGENT): 47429 ms
Total Talk Time (CUSTOMER): 119909 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/542c6cee-76e3-43af-b31f-debf2e3e9784_20250610T13:36_UTC.wav
--------------------------------------------
[CUSTOMER][NEUTRAL] Hey, hi [PII]. I am [PII] from Medical University Hospital to check on claim status.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, and that's number [PII]. It's a direct line.
[AGENT][NEUTRAL] OK, thank you. And the policy number for the patient?
[CUSTOMER][NEUTRAL] Yes, and that's gonna be.
[CUSTOMER][NEUTRAL] Number 02372298.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Yes hello.
[CUSTOMER][NEUTRAL] Yes, and this is for [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] of service and bill charges.
[CUSTOMER][NEUTRAL] Yes, and that's for uh [PII] for $134 even.
[CUSTOMER][NEUTRAL] I was.
[AGENT][NEUTRAL] A claim was received on [PII]. Process 425, [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Uh, it looks like the calendar year maximum benefit payable has been exhausted.
[CUSTOMER][NEUTRAL] Uh, OK. And what was the maximum allowed unit for the calendar year and when was this exhausted, please?
[CUSTOMER][NEUTRAL] They really
[AGENT][NEUTRAL] Uh, let me pull that up. One moment.
[CUSTOMER][NEUTRAL] Yeah sure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] um.
[AGENT][NEUTRAL] Uh, maximum amount is $200.01 day per calendar year.
[CUSTOMER][NEUTRAL] OK, and may I know when was the sex, sir? Do you have the details?
[AGENT][NEUTRAL] Uh well
[CUSTOMER][NEUTRAL] I was on.
[CUSTOMER][NEUTRAL] The inward one, the one doesn't matter.
[AGENT][NEUTRAL] Um, give me one moment.
[CUSTOMER][NEUTRAL] Mm yeah, sure.
[CUSTOMER][NEGATIVE] They don't.
[CUSTOMER][NEUTRAL] Alright so.
[AGENT][NEUTRAL] Uh, it looks like it was met with claims we received prior for a February date of service.
[AGENT][NEUTRAL] That were received in March.
[AGENT][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] It's like the benefit most exhaustion on [PII]. Am I correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and uh thank you for that information. Well, in that case, and that's it for the day. Can I have a reference number for the call, please?
[AGENT][NEUTRAL] That's my name, [PII], and today's date.
[CUSTOMER][POSITIVE] Thank you, [PII], and that's it for the day. Have a nice day.
[AGENT][POSITIVE] Thank you for calling APL. You as well. Bye-bye.