AccountId: 011433970860
ContactId: 9ca351cb-ccb7-4fe4-bca2-9b56bfd7b6dc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 216759 ms
Total Talk Time (AGENT): 62253 ms
Total Talk Time (CUSTOMER): 102587 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/9ca351cb-ccb7-4fe4-bca2-9b56bfd7b6dc_20250609T18:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes ma'am, uh, my name is [PII]. I'm calling from Spartanburg Regional Medical Center and I'm not quite sure that I'm in the right department. Um, I just had a question about a patient's, uh, claim, um, and if there was any patient responsibility for him, um, and it's a [PII] old.
[AGENT][NEUTRAL] OK. Yes, ma'am. I'll be able to assist you with claim status. Um, first, could I get a good callback number?
[CUSTOMER][NEUTRAL] Mhm [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yes, um, so what I've got.
[CUSTOMER][NEUTRAL] Is 02415343.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] [PII], um, last name is [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And then, well, he, I guess he's got two, the last one is spelled [PII]
[AGENT][NEUTRAL] And the date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, um, so this one is [PII].
[CUSTOMER][NEUTRAL] Um, the total charges are $3,546.62.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. This is for the ER visit?
[CUSTOMER][NEUTRAL] E
[CUSTOMER][NEUTRAL] Mhm yes ma'am.
[AGENT][NEUTRAL] OK. Yes, ma'am. I'm showing that we received that claim on [PII].
[AGENT][NEUTRAL] It processed on [PII].
[AGENT][NEUTRAL] And it paid out for $100 even.
[AGENT][NEUTRAL] And that's the daily benefit amount for ER visits under this policy.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] OK, um, would the rest.
[CUSTOMER][NEUTRAL] The the EOB we've got just says max benefits um so that would mean that the patient's just responsible for the remaining balance is that right?
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, um, the EOB we got was just a little confusing and I just wanted to just make sure I was putting the notes in his account right, um, OK, well, great, thank you for looking at that. I appreciate it. um, can I have um a call reference number? I'll just go ahead and update the notes on his account.
[AGENT][NEUTRAL] Um, yes, ma'am. The reference number is my name and today's date. My name is [PII]. Um it's spelled [PII] Last initial is [PII] and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] They
[CUSTOMER][POSITIVE] Uh, no, that was it. Thank you for your help. I hope you have a great day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thanks bye.