AccountId: 011433970860
ContactId: 624352db-c9c4-4d6b-921b-2a51b667c870
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1427569 ms
Total Talk Time (AGENT): 92103 ms
Total Talk Time (CUSTOMER): 79837 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/624352db-c9c4-4d6b-921b-2a51b667c870_20250616T19:19_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yeah [PII], see, I am calling um regarding a claim that we received. I just wanted to make sure that it was um correct. We're I'm part of a medical office here.
[AGENT][NEUTRAL] OK. May I ask who's calling?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back.
[CUSTOMER][NEUTRAL] Sure thing [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Do you have their policy number?
[CUSTOMER][NEUTRAL] Yes, 02559705.
[AGENT][NEUTRAL] And do you happen to have the claim number?
[CUSTOMER][NEUTRAL] Um, yes, one second here, I do have that.
[CUSTOMER][NEUTRAL] Pulled up on one of these.
[CUSTOMER][NEUTRAL] Maybe I don't hard to go.
[CUSTOMER][NEUTRAL] Sorry, I had it pulled up. I don't know where it went. One second here.
[AGENT][NEUTRAL] Yes, OK.
[CUSTOMER][NEUTRAL] There it was
[AGENT][NEUTRAL] What's the patient's name?
[CUSTOMER][NEUTRAL] OK, um, it, uh, I have a reference number. Oh, that's their policy number, um.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] The claim number is 359.
[CUSTOMER][NEUTRAL] 879 4.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And the date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII] and you were just wanting to know about this claim?
[CUSTOMER][NEUTRAL] Yeah, I was so I know I see that it's um not necessarily denied but it's patient responsibility.
[AGENT][NEUTRAL] OK, I can help you with that. One moment.
[AGENT][NEUTRAL] The calendar year maximum for outpatient office visits due to sickness and or accident has been met for this calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do they what is the calendar year January to December for this specific policy, is that correct?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] And they get 4 per calendar year.
[CUSTOMER][NEUTRAL] OK, so she's only been seen once here, so she's probably been seen somewhere else then, OK, for her.
[AGENT][NEUTRAL] At $50 per office visit and any benefits given over the phone is not a guarantee of payment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, sounds good. Can I get a reference number for the call?
[AGENT][NEUTRAL] We do not have reference numbers. You use my name in today's date. My name is [PII] My [PII]
[AGENT][NEUTRAL] Is there anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Uh, I think that's it for today. Thank you very much for your help.
[AGENT][POSITIVE] Thank you, [PII] for calling IPO. You have a good afternoon.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.
[AGENT][NEUTRAL] Did you fart?
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[AGENT][POSITIVE] Oh, I love that.
[AGENT][NEGATIVE] 70, you lost your fucking mind.
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[AGENT][NEGATIVE] My shit for no hunt at all.
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[AGENT][POSITIVE] Amazing.
[AGENT][NEUTRAL] Yeah.
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