AccountId: 011433970860
ContactId: 5822138c-3670-4b76-ad89-1bcb1341808f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 274260 ms
Total Talk Time (AGENT): 75326 ms
Total Talk Time (CUSTOMER): 94827 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/5822138c-3670-4b76-ad89-1bcb1341808f_20250501T18:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] and I'm calling you from provider's office. I'm looking for the same status. Could you help me with that?
[AGENT][NEUTRAL] Yes, I can help with claim status, [PII]. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Uh, my callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And you have the policy number of the patient?
[CUSTOMER][NEUTRAL] 02474940.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] And the date of service and bill charges?
[CUSTOMER][NEUTRAL] Uh, the date of service is.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] April [PII] bill amount is $158.
[AGENT][NEUTRAL] Did you say [PII]?
[CUSTOMER][NEUTRAL] No, no, after [PII].
[AGENT][NEUTRAL] 10:15? OK.
[CUSTOMER][NEUTRAL] For the amount of
[AGENT][NEUTRAL] OK, that's 1015 2024.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] I don't show a claim on file for that date of service.
[CUSTOMER][NEUTRAL] But we have received the payment for this claim, but I don't know because we don't have the UV at man, but we, but the payment is posted in my system, uh, just a second.
[AGENT][NEUTRAL] OK, so it's [PII].
[CUSTOMER][NEUTRAL] No, no, it's [PII].
[AGENT][NEUTRAL] [PII], I'm sorry, I can't understand.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] April
[CUSTOMER][NEUTRAL] Yes, yes, [PII].
[CUSTOMER][NEUTRAL] Yeah, after, right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] [PII]. It's good.
[AGENT][NEUTRAL] OK, I found it. Hold on one moment, OK?
[CUSTOMER][NEGATIVE] Mhm. Sure. I'm in a hurry.
[AGENT][NEUTRAL] OK, and you were checking on the payment, is that correct? It looks like we paid 75.
[CUSTOMER][NEUTRAL] Just a second please, uh, what's your name first of all, uh, [PII], right? you spell that?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] OK.
[CUSTOMER][NEUTRAL] [PII], uh, so [PII], may I know the one it one another payment was received by you guys?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] May I know when the claim was received?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Uh, the claim was received on 82.
[CUSTOMER][NEUTRAL] I received it.
[AGENT][NEUTRAL] 82124.
[AGENT][NEUTRAL] Process 823 24.
[CUSTOMER][NEUTRAL] 821 or 202.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] On [PII]. OK, how much are you allowed in it?
[AGENT][NEUTRAL] We paid 75.
[CUSTOMER][NEUTRAL] 75 and allowed also 75, right?
[CUSTOMER][NEUTRAL] Is any patient responsibility?
[AGENT][NEUTRAL] Um, we don't determine patient responsibility. It's a supplemental policy.
[CUSTOMER][NEUTRAL] Bye
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh but we have and then the contractual write up amount is $83 right.
[AGENT][NEUTRAL] Uh, we just, the policy pays $75 maximum for an office visit, and that's what was paid on the policy.
[CUSTOMER][NEUTRAL] OK, I know that. So I know that the right, the contractual amount right of amount, it's $83 right on the EOB.
[AGENT][NEUTRAL] We, we don't have a write off amount. It's this is a supplemental hospital indemnity plan.
[AGENT][NEUTRAL] So there's there's no contractual allowable or any of that. It just pays a certain dollar amount for certain services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much.