AccountId: 011433970860
ContactId: 8a834495-f07e-4ba0-93e6-4605d9974e3b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 281029 ms
Total Talk Time (AGENT): 95837 ms
Total Talk Time (CUSTOMER): 71831 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/8a834495-f07e-4ba0-93e6-4605d9974e3b_20250404T17:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from Pri Site. Could you please help me with the claim status?
[AGENT][NEUTRAL] Yes, I can check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][POSITIVE] OK, thank you [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] The policy number, please?
[CUSTOMER][NEUTRAL] OK. Policy number. I it's 10 sorry, 01882823.
[AGENT][NEUTRAL] OK, and then uh what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] It's [PII], and the date of birth for this patient is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that um. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then what was that bill amount, please?
[CUSTOMER][NEUTRAL] $5370.80.
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What was the name of this provider's office?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. OK, so we did uh receive this claim. We paid a benefit of $50 and that did meet their maximum for the date of service.
[CUSTOMER][NEUTRAL] Sorry, uh, so the patient plan has maximized, right?
[AGENT][NEUTRAL] Yes, per date of service for emergency room visits pays a maximum of $50.
[CUSTOMER][NEUTRAL] So, uh, for the rest of the amount, we can, uh, bill that to the patient.
[AGENT][NEUTRAL] We don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] OK. Could you please fax me the EOB for this one? And also provide the claim number. Actually, I don't have the claim number.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Yes, that claim number is 3569728.
[AGENT][NEUTRAL] And then I can take that fax number whenever you're ready.
[CUSTOMER][NEUTRAL] All right, uh, fax number.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm going to read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, and would I just put this to your attention, [PII]?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] OK, alright, I will go ahead and get that sent now. It should get it here within about 10 minutes or so. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, no, just the car reference number for today's call.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII], last initial is [PII]
[CUSTOMER][POSITIVE] Thank you very much.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] OK