AccountId: 011433970860
ContactId: a5b1c885-a259-40aa-8cb2-32a2e4918e6e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217479 ms
Total Talk Time (AGENT): 86415 ms
Total Talk Time (CUSTOMER): 70272 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/a5b1c885-a259-40aa-8cb2-32a2e4918e6e_20250507T20:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling with Kramer Woman's Care. We received a check and an EOB, um, I'm just trying to find out if the patient's responsible for anything. It doesn't specify on the EOB.
[AGENT][NEUTRAL] OK, I can help you with the claim, Ms. [PII]. May I please get your callback number just in case the call is disconnected?
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Sure, I'll give you my direct number. It's [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] That's [PII]. Date of birth is [PII] and her policy number is 02598062.
[AGENT][POSITIVE] Thank you. Alright, let me look up her policy real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then can you give me uh the claim number please?
[CUSTOMER][NEUTRAL] Yes, claim number 3592783.
[AGENT][NEUTRAL] OK, let me look that claim up.
[AGENT][NEUTRAL] It's gonna be just a moment.
[CUSTOMER][POSITIVE] Sure, no problem.
[AGENT][NEUTRAL] OK, I do see that you did receive a check for $50 is that correct?
[CUSTOMER][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] OK. So that is to cover.
[AGENT][NEUTRAL] On procedure code number 99214.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let me see what the remarks say.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so with that check, the maximum benefit payable for the data service was met?
[AGENT][NEUTRAL] For this claim and we don't give patient responsibility we allow the um providers to determine.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] How they want to proceed.
[CUSTOMER][NEUTRAL] OK, so it's, it's basically up to us if we're gonna build a patient or not?
[AGENT][POSITIVE] Right. Correct.
[CUSTOMER][NEUTRAL] OK, I haven't seen that before. OK, so the $50 924 and then um the CBT 76,830 that didn't pay because of the benefit maxed out.
[AGENT][POSITIVE] Correct, yes, it matched out for that day.
[CUSTOMER][POSITIVE] It's right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK great and do you have a call reference number?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name, [PII], and today's date. Can you spell it [PII]
[CUSTOMER][POSITIVE] All right, thank you so much I appreciate it.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Is that everything I can help you with before we go?
[CUSTOMER][NEUTRAL] Yes ma'am, that was it for now.
[AGENT][POSITIVE] OK, well you have a good rest of your week and thank you for calling APL.
[CUSTOMER][POSITIVE] Thanks you too bye bye.
[AGENT][NEUTRAL] Bye bye.