AccountId: 011433970860
ContactId: 595640ba-95f3-4352-ae47-82c26d3fd15f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180539 ms
Total Talk Time (AGENT): 72970 ms
Total Talk Time (CUSTOMER): 45328 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/595640ba-95f3-4352-ae47-82c26d3fd15f_20250603T13:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning. My name is [PII]. I need to get on a claim.
[AGENT][POSITIVE] OK, [PII], happy to check on a claim for you. Do we have
[CUSTOMER][NEUTRAL] IAC professor.
[CUSTOMER][NEUTRAL] Services.
[AGENT][NEUTRAL] Do we have the policy number?
[CUSTOMER][NEUTRAL] Yes, [PII]
[CUSTOMER][NEUTRAL] 02467446.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, let me pull that up.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, [PII]. Her date of birth is [PII].
[AGENT][POSITIVE] Perfect and then data service?
[CUSTOMER][NEUTRAL] Sure, and the date of service was [PII] for $296.77.
[AGENT][NEUTRAL] Did you say $296.70? The phone kind of cut out.
[CUSTOMER][NEUTRAL] 0 77 cents. I know it's my computer phone, sorry.
[AGENT][NEUTRAL] OK, that's that's OK. I just want to make sure I heard you right, right, one second.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Alright, [PII], so it looks like we did receive a claim for this theater service. The claim was received on [PII]. It was denied assessed on [PII].
[AGENT][NEUTRAL] The calendar year maximum on diagnostic services had already been met.
[CUSTOMER][NEUTRAL] OK, so it's excuse me, it's a patient responsibility then, correct?
[AGENT][NEUTRAL] Yeah I mean we don't know about patient responsibility that's up to the facility or provider.
[CUSTOMER][POSITIVE] OK, but you basically I'm just awarded this way, the benefits are maxed correct.
[AGENT][POSITIVE] Yes, correct, because it's a limited benefit plan and it was all used, correct.
[CUSTOMER][NEUTRAL] That's what I was trying to tell them. I, I thought I was right on this one. And then [PII], do you have a reference number for this call?
[AGENT][NEUTRAL] Yeah, absolutely. Call reference is my name with today's date. My name again is [PII] and that is [PII] Last initial to my name is [PII].
[CUSTOMER][POSITIVE] OK and thank you so much and you have an awesome day.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] You too bye bye.