AccountId: 011433970860
ContactId: 85d53f25-dfbb-48fe-8226-c12068690db0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 267779 ms
Total Talk Time (AGENT): 60715 ms
Total Talk Time (CUSTOMER): 79164 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/85d53f25-dfbb-48fe-8226-c12068690db0_20250401T18:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from our office. Uh, this call is regarding to check the status.
[AGENT][NEUTRAL] OK [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] He
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, do you have the policy number for the patient?
[CUSTOMER][NEUTRAL] Yes, sir. Patient policy number is
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 02555967
[AGENT][NEUTRAL] I don't
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Special name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And on the date of service?
[CUSTOMER][NEUTRAL] date of services.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the bill amount?
[CUSTOMER][NEUTRAL] $123.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I know
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, it looks like the maximum for this policy has been met for the service.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, yes. Could you please clarify?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Yes, sir. Could you please clarify the reason?
[AGENT][NEUTRAL] The maximum has been met for the confinement period.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Primary insurance I paid maximum amount, correct?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] primary.
[CUSTOMER][NEUTRAL] Hello. Primary insurance already paid maximum amount, correct?
[AGENT][NEUTRAL] Uh, that it's just the denial reason in our system is the maximum for this confinement period has been met.
[AGENT][NEUTRAL] I don't have anything that talks about the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] Uh, one and next data service.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Go on a date, next date of service for the patient.
[AGENT][NEUTRAL] Another date of service for the same patient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, what's that date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Build them out.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] $290.
[AGENT][NEUTRAL] 298
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEGATIVE] Uh, that was denied for the same reason, maximum for this confinement and paid.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello. Could you please spell and contact this number for?
[CUSTOMER][NEUTRAL] To this claim?
[AGENT][NEUTRAL] Uh, call call reference number is my name, [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] First initial of my last name is [PII] and today's date.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII], correct?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] Anything else I can help with?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] OK, thanks for calling APL have a good day.