AccountId: 011433970860
ContactId: 6f061b62-a6cd-4cdf-ab5c-3d326afa147f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275399 ms
Total Talk Time (AGENT): 105217 ms
Total Talk Time (CUSTOMER): 114994 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/6f061b62-a6cd-4cdf-ab5c-3d326afa147f_20250411T17:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[AGENT][POSITIVE] Good afternoon. Thank you for calling American Public Life. This is [PII]. How may I help you?
[AGENT][NEGATIVE] I'm disconnecting the call.
[CUSTOMER][NEUTRAL] Hello, this is [PII] calling on behalf of the provider.
[AGENT][NEUTRAL] [PII], how can I help you today?
[CUSTOMER][NEUTRAL] Yeah, just send the claim status.
[AGENT][NEUTRAL] I can verify claim status. May I have a policy number?
[CUSTOMER][NEUTRAL] Yeah, it is 01820389, M for Mike, L for Lima, number 8.
[AGENT][NEUTRAL] May I have a good callback number for you?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Is [PII]. Uh date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. May I have a date of service?
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[AGENT][NEUTRAL] Total bill amount?
[CUSTOMER][NEUTRAL] A bill amount of $4,288 even 4288.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] to check claim status as well. One moment.
[CUSTOMER][NEUTRAL] I is that is a self-service portal?
[AGENT][NEUTRAL] That is correct. You must register as a provider to use it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Still checking. One moment.
[CUSTOMER][NEUTRAL] Oh sure.
[AGENT][NEUTRAL] This processed under claim number?
[AGENT][NEGATIVE] 3570079. Looks like no benefits were payable. The outpatient per day max was met, so no benefits were payable on this claim.
[CUSTOMER][NEUTRAL] Outpatient maximum benefit exhausted.
[AGENT][NEUTRAL] It was met
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] And, could you please help me out how many, uh, like how many visits the patient has been met?
[AGENT][NEUTRAL] The benefit amount allows per calendar day $500.
[AGENT][NEUTRAL] So that max was met prior to the claim being received.
[CUSTOMER][NEUTRAL] 10, OK.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] OK, what's the, uh, another claim received it.
[AGENT][NEUTRAL] Yes, the claim was received on [PII]. It processed and denied on [PII].
[CUSTOMER][NEUTRAL] OK, uh, that's, and, uh, I request you to send the UOB copy to the fax number.
[AGENT][NEUTRAL] May I have your fax number and I'll send it right over.
[CUSTOMER][NEUTRAL] Yeah, it's 615.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I have [PII].
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, I'll fax this right over. Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No, and could you please spell your name for me?
[AGENT][NEUTRAL] Yes, it's [PII] Last initial is [PII]
[CUSTOMER][NEUTRAL] OK. Call reference number.
[AGENT][NEUTRAL] It will be my name along with today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much and have a great day.
[AGENT][POSITIVE] You're so welcome, [PII], and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Bye bye.