AccountId: 011433970860
ContactId: 85d8f8e0-9850-4a61-a98d-b37365bdf74b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 393510 ms
Total Talk Time (AGENT): 103550 ms
Total Talk Time (CUSTOMER): 160685 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/85d8f8e0-9850-4a61-a98d-b37365bdf74b_20250409T18:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I am calling in regards to a patient um with the APL insurance checking for eligibility and claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with eligibility and claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And the policy number of the patient?
[CUSTOMER][NEUTRAL] 02582713
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Truly, [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I show she's active [PII]. Policy is, um, current, and you said you had a claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, I don't show any claims on file.
[CUSTOMER][NEUTRAL] Um, I, I.
[CUSTOMER][NEUTRAL] Well, I do show that.
[CUSTOMER][NEUTRAL] This claim did pay except for $30 and I was gonna check on that.
[AGENT][NEUTRAL] [PII] is the patient?
[CUSTOMER][NEUTRAL] And I is the patient.
[AGENT][NEUTRAL] Do you have an explanation of finish.
[CUSTOMER][NEUTRAL] What is that one for one.
[CUSTOMER][NEUTRAL] Yeah, hang on.
[CUSTOMER][NEUTRAL] Let me see if this is the right one.
[CUSTOMER][POSITIVE] Yes it is OK.
[CUSTOMER][NEUTRAL] Um, so I have a check number if that'll help.
[AGENT][NEUTRAL] There are, um, OK, hold on one moment. Is there a claim number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I do not have one no.
[CUSTOMER][NEUTRAL] Oh wait, is this a claim number?
[CUSTOMER][NEUTRAL] Start with a P 905.
[AGENT][NEUTRAL] Um, no.
[CUSTOMER][NEUTRAL] That looks like it's ours. Yeah, that's ours. OK.
[AGENT][NEUTRAL] What was the check number?
[CUSTOMER][NEUTRAL] 2033.
[CUSTOMER][NEUTRAL] 841.
[CUSTOMER][NEUTRAL] It paid $75.
[AGENT][NEUTRAL] Yeah, I don't have any claims on file for anyone, but let me look up the check number. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] This is for 33.
[CUSTOMER][NEUTRAL] Service is 22525.
[CUSTOMER][NEUTRAL] If you say
[AGENT][NEUTRAL] And let's see here.
[AGENT][NEUTRAL] Is this for medical services or?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, this for medical? OK.
[AGENT][NEUTRAL] OK, because the policy number you gave me is for a dental plan. So let me see if I can look up the other.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me look at this hang on.
[CUSTOMER][NEUTRAL] Let me make sure that it's not for dental. Uh, we don't usually charge for dental. Yeah, this is an office visit for medical. I wonder if it was.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Like paid by accident.
[AGENT][NEUTRAL] Uh, no, they have a me.
[CUSTOMER][NEUTRAL] I don't know because there's 2 of them and they were both paid.
[AGENT][NEUTRAL] They have a medical plan, the one that you gave me was for dentals. That's why I wasn't seeing it.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what was the date of service again? I'm sorry.
[CUSTOMER][NEUTRAL] Um, the one I'm looking at is [PII] for 233.
[AGENT][NEUTRAL] OK, yes.
[AGENT][NEUTRAL] I see that one. OK, for $75 looks like we paid. Um, this is a hospital indemnity plan, so that was the benefit that was available on the policy.
[CUSTOMER][NEUTRAL] OK this is hospital.
[CUSTOMER][NEUTRAL] It's the place of services office number [PII].
[AGENT][NEUTRAL] Right, so this.
[CUSTOMER][NEUTRAL] That's why I'm all confused.
[AGENT][NEUTRAL] The type of plan that they have is a supplemental hospital indemnity plan. That's the type of plan it is. So it basically pays out certain dollar amount for certain types of services for office visits, it pays a max of $75.
[CUSTOMER][NEUTRAL] OK, so then.
[CUSTOMER][NEUTRAL] The let's see what that I I think that extended.
[CUSTOMER][NEUTRAL] Complex add-on. OK, yeah, OK, so office visit is a max of $75.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] That is perfect. That's what I needed. That is what I'll put in my notes and then send the rest to the patient.
[CUSTOMER][NEUTRAL] And one more question, do you have a reference number?
[AGENT][NEUTRAL] Uh, we just use our my name and today's date. So [PII] is my last, uh, first initial last name, and today's date.
[CUSTOMER][NEUTRAL] OK, that'll work.
[CUSTOMER][POSITIVE] I appreciate that thank you so much.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a good day. Bye.
[CUSTOMER][POSITIVE] Have a good day.