AccountId: 011433970860
ContactId: 8a1849bd-ed46-4da1-8488-fbf1408efc8f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 428279 ms
Total Talk Time (AGENT): 74321 ms
Total Talk Time (CUSTOMER): 96694 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/8a1849bd-ed46-4da1-8488-fbf1408efc8f_20250625T14:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help?
[CUSTOMER][NEUTRAL] Hi, this is [PII], and I'm calling from provider office to check on a claim status, and my callback number is [PII] with direct line or extension.
[AGENT][NEUTRAL] OK, no good. Do you have the policy number for the patient, and I can help you with claim status.
[CUSTOMER][NEUTRAL] Yeah, for the policy number is 01659538 M as in Mary, L as in Lima 7.
[AGENT][NEUTRAL] Your name and date of birth?
[AGENT][NEUTRAL] a patient name.
[CUSTOMER][NEUTRAL] Name is
[CUSTOMER][NEUTRAL] The patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Day of service and bill charges.
[CUSTOMER][NEUTRAL] [PII] will the amount $1,87 even.
[AGENT][NEUTRAL] I don't show the claim on, well, this is an old policy. OK, this policy termed in 24. Let me look up the right policy.
[AGENT][NEUTRAL] And what was the bill charges again?
[CUSTOMER][NEUTRAL] $1,807.
[AGENT][NEUTRAL] OK, uh, looks like we received the claim on 4-10-2025.
[AGENT][NEUTRAL] Process [PII].
[AGENT][NEUTRAL] And we need a copy of the primary explanation.
[CUSTOMER][NEUTRAL] Need primary UB.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh-huh. Ma, is it, uh, you could not provide the primary information, right?
[AGENT][NEUTRAL] Uh, primary is
[AGENT][NEUTRAL] Oh we sure they have Aetna.
[CUSTOMER][NEGATIVE] Yeah no.
[CUSTOMER][NEUTRAL] May I know the last coordination of benefit update date?
[AGENT][NEUTRAL] Uh, it was in [PII].
[CUSTOMER][NEUTRAL] May I know the claim number?
[AGENT][NEUTRAL] 358-858-0
[CUSTOMER][NEUTRAL] Yes, shall we move on to the next member?
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] OK, policy number?
[CUSTOMER][NEUTRAL] The policy number is
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] Um, that's our payer ID. Do you have the policy number?
[CUSTOMER][NEUTRAL] Uh, one second.
[CUSTOMER][NEUTRAL] Yeah, the policy number is um.
[CUSTOMER][NEUTRAL] 02441483.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Yeah, for the date of service is [PII] bill amount $1,807 even.
[AGENT][NEUTRAL] Receive 4 1525, process 4 1725.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Maximum benefit payable for date of service was met.
[CUSTOMER][NEUTRAL] Sorry, maximum benefit payable.
[AGENT][NEUTRAL] Or date of service was met.
[CUSTOMER][NEUTRAL] Uh, for the maximum benefit met, is it under the
[CUSTOMER][NEUTRAL] Unit wise or is it the amount will be met?
[AGENT][NEUTRAL] The dollar amount.
[CUSTOMER][NEUTRAL] How much is the metable amount?
[AGENT][NEUTRAL] 500
[CUSTOMER][NEUTRAL] So the balance amount is member responsibility, right?
[AGENT][NEUTRAL] We can't instruct on patient responsibility. It's a secondary policy, so I I can't tell you if it's patient responsibility.
[CUSTOMER][NEUTRAL] Mhm, yeah, may I know the claim number?
[AGENT][NEUTRAL] 359-041-6.
[CUSTOMER][NEUTRAL] May I know the call reference?
[AGENT][NEUTRAL] It's my name is [PII], and today's date.
[CUSTOMER][POSITIVE] Yeah, right, thank you so much for the information. Have a good day. Bye bye.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye-bye. Bye.