AccountId: 011433970860
ContactId: 63d067d6-f44f-4afa-ab71-5aa3b35c986b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 307260 ms
Total Talk Time (AGENT): 112458 ms
Total Talk Time (CUSTOMER): 83403 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/63d067d6-f44f-4afa-ab71-5aa3b35c986b_20250602T17:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] from provider office. I would like to check the claim status.
[AGENT][NEUTRAL] I can verify claim status. May I have a policy number?
[CUSTOMER][NEUTRAL] OK. So the policy number I have is
[CUSTOMER][NEUTRAL] 02284366
[AGENT][POSITIVE] Thank you. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII] without extension.
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] First name, [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. May I have a date of service?
[CUSTOMER][NEUTRAL] [PII], total charge amount, $465 even.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] to check claim status as well.
[AGENT][NEUTRAL] One moment, I'll pull this up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like this one.
[AGENT][NEUTRAL] I'm sorry, the total bill amount was 465?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so this one processed under claim number 358-81887.
[AGENT][NEUTRAL] This one processed the benefit amount of $75 to the provider.
[AGENT][NEUTRAL] And this one processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like the benefit amount allows $75 per day. So it was applied to 99213. The other line, no benefits were payable, the benefit only allows $75 per day.
[CUSTOMER][NEUTRAL] OK. So there is a total paid amount of $75 with zero member liability.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] So the total paid amount is $75 is it right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEGATIVE] And 0 member responsibility.
[AGENT][NEUTRAL] If there's any patients responsibility, it becomes the member's responsibility. The benefit only allows $75.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What's the check number?
[AGENT][NEUTRAL] It is.
[AGENT][NEUTRAL] 203-854-1.
[CUSTOMER][NEUTRAL] And what's the check date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, just give me a second.
[CUSTOMER][NEGATIVE] OK. I just have one patient and I'm done with it. Uh, I just need to confirm one thing, the CBT9 99401. So this CBT card denied because no benefits were payable.
[CUSTOMER][NEUTRAL] And the benefits
[CUSTOMER][NEUTRAL] Our pay will only allows $5.
[AGENT][NEUTRAL] No, this claim has a daily benefit of $75. So for 99401, the benefit max was met for that day of service.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] Uh, OK. Thank you, thank you very much for your time. I just need the call reference number.
[AGENT][NEUTRAL] Yes, the call reference will be my name which is [PII] Last initial is [PII] along with today's date.
[CUSTOMER][POSITIVE] OK. Thank you, thank you very much for your time. Have a good day.
[AGENT][POSITIVE] [PII], you're so welcome, and thank you for calling American Public Life. Have a great day. Bye-bye.