AccountId: 011433970860
ContactId: c14c7b67-35aa-47f5-9787-fe8fcfea7df5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167869 ms
Total Talk Time (AGENT): 76477 ms
Total Talk Time (CUSTOMER): 67238 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/c14c7b67-35aa-47f5-9787-fe8fcfea7df5_20250109T21:51_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], can you help me in reference to this claim? You just pay $50 out of $1300 plus bill. Um, I just want to know why.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I sure can help you with the claim. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that, and [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 02557140.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] As in MM is the last um spelling of the name. [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And what is the date of service for the claim and the total bills?
[CUSTOMER][NEUTRAL] This [PII] $1,39999.45.
[AGENT][NEUTRAL] Alrighty, and thank you for verifying. Hold on one moment.
[AGENT][NEUTRAL] So I wanted to know why $50 was applied. OK. So, for their um policy, they have an emergency room benefit. It pays up to 2 times per calendar year at a max of $50 so that $50 was applied to this claim.
[CUSTOMER][NEUTRAL] So the rest is discount.
[CUSTOMER][NEUTRAL] Or we uh we have to be the patient.
[AGENT][NEUTRAL] Now, we don't determine patient responsibility because we're not a major insurance company, um, it would just be whatever your procedures are if there's an outstanding balance.
[CUSTOMER][NEUTRAL] You don't determine the what?
[AGENT][NEUTRAL] We don't determine patient responsibility because we're not a major medical insurance company.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] You're not a major insurance, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Insurance company. OK. Thank you and a reference for this call.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] All right thank you bye bye.
[AGENT][POSITIVE] You're very welcome. Thanks for calling APL and Happy [PII].
[CUSTOMER][POSITIVE] Happy [PII], bye.
[AGENT][POSITIVE] Thank you. Bye-bye.