AccountId: 011433970860
ContactId: 61c30a39-afaf-4826-9215-037cf29e71d3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235779 ms
Total Talk Time (AGENT): 62527 ms
Total Talk Time (CUSTOMER): 95834 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/61c30a39-afaf-4826-9215-037cf29e71d3_20250605T20:12_UTC.wav
--------------------------------------------
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Can you hear me?
[CUSTOMER][NEUTRAL] Hello. Yes, I can hear you. Hello.
[AGENT][NEUTRAL] Hello?
[AGENT][POSITIVE] OK, how can I help you today?
[CUSTOMER][NEUTRAL] Yes, I can hear you.
[CUSTOMER][NEUTRAL] I want to know a claim status for a patient a bill status.
[AGENT][NEUTRAL] OK, I can help you with claim status. Could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] I promise, do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And policy number for the patient?
[CUSTOMER][NEUTRAL] Uh, the policy number for the patient is.
[CUSTOMER][NEUTRAL] 02469147
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth for [PII] is [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Uh, the date of service for the patient is [PII] and the bill charges for full 10 is.
[CUSTOMER][NEUTRAL] $5350.76 5350.76.
[AGENT][NEUTRAL] Uh, we received the claim on 5-1-2024. It was processed 52-2024.
[AGENT][NEUTRAL] And made a payment of $1000.
[CUSTOMER][NEUTRAL] OK, uh the remaining amount is the patient responsibility or what?
[AGENT][NEUTRAL] Um, we can't determine patient responsibility as a secondary policy.
[CUSTOMER][NEUTRAL] This is a secondary policy?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Do you have information regarding uh primary policy?
[AGENT][NEUTRAL] Um, and it's actually, it's a supplemental policy. It's not a true secondary, it's just a supplemental policy. Um, I don't show any primary insurance on file.
[CUSTOMER][NEUTRAL] OK, so how they can describe it as a secondary if there's no primary insurance on file?
[AGENT][NEUTRAL] It's a supplemental. I misstated. It's a supplemental, not secondary, supplemental.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Supplemental. OK, so you are saying that $1000 are paid and remaining is not the patient responsibility. You can determine is the patient responsibility, correct?
[AGENT][NEUTRAL] We cannot determine patient responsibility.
[CUSTOMER][NEUTRAL] And claim is processed as secondary.
[AGENT][NEUTRAL] Claim is processed as a supplemental. This is a supplemental policy, so we've processed it according to the policy.
[CUSTOMER][NEUTRAL] OK, it's a limited benefit policy, correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, on your side is, uh, on the explanation of benefits, the amount is showing as patient responsibility or not?
[AGENT][NEUTRAL] It won't say a patient responsibility. It'll just show what we paid.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, what is your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh, [PII] and the reference number for the call, [PII].
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][POSITIVE] Thank you so much for your time.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day. Bye-bye.