AccountId: 011433970860
ContactId: 8c9023c1-5f67-4322-9a4c-828d7a2f6089
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229059 ms
Total Talk Time (AGENT): 91998 ms
Total Talk Time (CUSTOMER): 93843 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/8c9023c1-5f67-4322-9a4c-828d7a2f6089_20250122T13:42_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh hi, this is [PII]. That is [PII] calling from provider's office to check on claims.
[AGENT][NEUTRAL] You said S [PII]?
[CUSTOMER][NEUTRAL] Yeah, right.
[AGENT][NEUTRAL] OK, and you're checking claim status?
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] OK, we can assist you. What's the policy number?
[CUSTOMER][NEUTRAL] Can you please check
[CUSTOMER][NEUTRAL] Uh yes, that is 017.
[CUSTOMER][NEUTRAL] 553-39
[AGENT][NEUTRAL] OK, and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Your phone number?
[CUSTOMER][NEUTRAL] Mhm. Yeah, that's the phone number.
[AGENT][NEUTRAL] Can you repeat that for me? Repeat that please.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that information. You can also check your status on our online service center at [PII], and I can help you set the account up before we you know, disconnect the line. Can you verify the um patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That was the patient's name, that is [PII] the [PII].
[AGENT][NEUTRAL] OK, I heard you. I was just confirming, thank you. And what's the date of service?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII], billed amount is 2 $400 even.
[AGENT][NEUTRAL] What's the total amount?
[CUSTOMER][NEUTRAL] $400 even.
[AGENT][NEUTRAL] 0, 400. 1 moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the procedure code on the claim?
[CUSTOMER][NEUTRAL] 76,830.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the ELB was received [PII], processed on the [PII], uh, issuing a payment of $200 which is a maximum benefit. The claim number.
[AGENT][NEUTRAL] It's 35 uh-huh, let me know when you're ready.
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Uh yeah. What is the claim number?
[AGENT][NEUTRAL] The claim number is 351-954-5 and any other questions we can help with today?
[CUSTOMER][NEUTRAL] Uh, yes, actually, uh, my question was primary has been processed $261.87 but you guys have only paid $200. So what was the remaining amount, $61.87? Is that the maximum benefit?
[AGENT][NEUTRAL] As I stated earlier, 200 exhausted that benefit, so that's all that was available.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] So max benefit in what um in like dollars?
[AGENT][NEUTRAL] We pay $200 so yes, it's $4.
[AGENT][NEUTRAL] Not days.
[CUSTOMER][NEUTRAL] Dollars, uh, what is the limit for the day?
[AGENT][NEUTRAL] 200
[CUSTOMER][NEUTRAL] 200 for the day or for the CPT?
[AGENT][NEUTRAL] Per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, all right, can I have a reference number?
[AGENT][NEUTRAL] You'll use my name in today's date is your reference, [PII], first initial of my last name is [PII] Any other questions I can help with today, [PII]?
[CUSTOMER][POSITIVE] Nothing. Thank you so much. Have a great day.
[AGENT][POSITIVE] You're welcome thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] You too.