AccountId: 011433970860
ContactId: 75d907f4-f23a-4720-a593-e21c92f40107
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163800 ms
Total Talk Time (AGENT): 68847 ms
Total Talk Time (CUSTOMER): 49375 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/75d907f4-f23a-4720-a593-e21c92f40107_20250402T18:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Wake Ms calling to check claim status.
[AGENT][NEUTRAL] I'm sorry, what's your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK, and you're checking claim status, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] I have 02449737.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] [PII] thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] Alright, thanks for that information. Can I have her claim history pulled up um, what's the date of service of her claim?
[CUSTOMER][NEUTRAL] It's an older claim 512024 for um $813.
[AGENT][NEUTRAL] Is it more than one line on the claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what are the procedure codes?
[CUSTOMER][NEUTRAL] 205-51.
[CUSTOMER][NEUTRAL] 76942 and 3301
[AGENT][POSITIVE] OK, I see it. Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So this claim was processed on the [PII]. Uh, there was no payment made on this one. It looks like the maximum outpatient benefit is exhausted for the calendar year.
[CUSTOMER][NEUTRAL] OK, so is that patient responsibility.
[AGENT][NEUTRAL] We do not determine patients responsibility, but their benefits were exhausted at that time. Did you need the claim number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, it's 347.
[AGENT][NEUTRAL] 6327.
[CUSTOMER][NEUTRAL] OK, can I get a reference number?
[AGENT][NEUTRAL] You'll use my name in today's date as reference, [PII] First initial last name is [PII], how do you spell your name with a [PII] or a [PII]?
[CUSTOMER][NEUTRAL] [PII] and [PII] is my last initial.
[AGENT][NEUTRAL] See, OK.
[AGENT][POSITIVE] OK, thank you. Anything else I can help with today? Alrighty, you're welcome. Thanks for calling ATL. Have a good day.
[CUSTOMER][POSITIVE] All right, thanks so much, [PII].
[CUSTOMER][NEUTRAL] That was it.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You too. Bye-bye.