AccountId: 011433970860
ContactId: a3d9b529-baca-4481-bee8-dd581de1a04f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226740 ms
Total Talk Time (AGENT): 124744 ms
Total Talk Time (CUSTOMER): 98977 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/a3d9b529-baca-4481-bee8-dd581de1a04f_20250204T22:24_UTC.wav
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[AGENT][NEUTRAL] Contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Um, my name is [PII], and I'm calling from Franciscan Physician Network. I'm calling to um check on the status of a claim for a patient of ours.
[AGENT][NEUTRAL] I can help with the claim and what is that policy number we're looking at today?
[CUSTOMER][POSITIVE] Great.
[CUSTOMER][NEUTRAL] Um, let me see here. It looks like 250-544-9.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] at [PII], so it's [PII] and date of birth is [PII] and I am so sorry but I didn't write down your name for my notes.
[AGENT][NEUTRAL] Uh, yeah, that's fine. My name is [PII] and uh what um yeah.
[CUSTOMER][NEUTRAL] [PII], I knew it was one I would know, but it was gone.
[AGENT][NEUTRAL] And I just need a callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. What date of service are we looking for for [PII]?
[CUSTOMER][NEUTRAL] It is [PII] and the bill amount is $280.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like your claim number is 35.
[AGENT][NEUTRAL] 49212.
[AGENT][NEUTRAL] Now
[AGENT][NEUTRAL] This is a limited benefit policy. What it does is it it pays a flat rate benefit for services um that uh that are covered. And in this case, uh on uh on this particular claim, the most that it will pay is $50.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, now, I, I realized that the charge was more than that, but the, the most of this policy will pay is $50. It's not major medical. Um, what it is is it's just a limited benefit hospital indemnity policy and that's what it's going to pay, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it looks like that was already sent out.
[CUSTOMER][NEUTRAL] OK, to us or to the patient?
[AGENT][NEUTRAL] It looks like it went to you. Um, let me just see where the, uh, where the check went here, um, what is it? OK, so it looks like the check went to, uh, Franciscan hysician Network. Does that sound right?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Yes, in [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Right, um, and let me just see, just to see where uh the check is here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm just going to check and see if it's.
[CUSTOMER][NEUTRAL] And do you have a check number by any chance on it?
[AGENT][NEUTRAL] I do. The check number is 2021891. Now, it went uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 1891 OK.
[AGENT][NEUTRAL] It looks like it was cashed on the [PII]. It would have been a Bank of Oklahoma check, yeah, so.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] OK, um, alright, I will look that up then and that was for this date of service, the [PII].
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] Did it OK and does it show um on that claim what the remaining amount is for the patient? like did you guys discount it or?
[AGENT][NEUTRAL] No, it's not a discount at all. Um, what it is is it, uh, yeah, it's just a very limited benefit policy. Um, it just, uh, it, it doesn't matter what the, uh, the charge amount is, you would only have paid that $50.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, well I will look into that and then um [PII], do you give reference numbers?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII], and we're gonna use that in today's date as a reference. Now, is there anything else at all I can help with? Any other claims, or is this the only one that we need to look at?
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] Um, not that I have in my work too right now, no, so we're good.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] OK, well thank you for contacting ATL. You have a good.
[CUSTOMER][POSITIVE] OK, thank you.