AccountId: 011433970860
ContactId: c213e7d4-8417-4453-abfb-407d975941d5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 276220 ms
Total Talk Time (AGENT): 104488 ms
Total Talk Time (CUSTOMER): 64918 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/c213e7d4-8417-4453-abfb-407d975941d5_20250114T16:58_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]. This is [PII] calling from Wellstar Medical Group.
[CUSTOMER][NEUTRAL] I'm calling because I'm looking at your um the EOB that we have and the remark code is a number one but I don't have the description page.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, spell your name for me.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Give me that one more time.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh, [PII]?
[CUSTOMER][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] OK, [PII], OK, and what is the claim number?
[CUSTOMER][NEUTRAL] It is 353-784-7.
[AGENT][NEUTRAL] OK, do you have the policy number?
[CUSTOMER][NEUTRAL] It is 254-9961.
[AGENT][NEUTRAL] OK, and you're calling from the provider's office?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what's a good phone number to make you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that and you're basically wanting to go over the remark code that's on that explanation?
[CUSTOMER][POSITIVE] Mhm it's the number one.
[AGENT][NEUTRAL] OK, OK, give me one second, let me pull up the information.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] What is the um patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's from [PII] [PII].
[AGENT][POSITIVE] Thank you for that.
[AGENT][NEUTRAL] Let me take a look at the claim and then I'll get you the remark code information.
[AGENT][NEUTRAL] 2549961.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 353-7847.
[AGENT][NEUTRAL] Is this from Wellstar Medical Group?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And I'm going to pull pull up what you're looking at.
[AGENT][NEUTRAL] Are you on page 2?
[AGENT][NEUTRAL] Of the explanation of benefits?
[CUSTOMER][NEUTRAL] Please.
[CUSTOMER][NEUTRAL] Page one.
[AGENT][NEUTRAL] Page one, OK.
[AGENT][NEUTRAL] Go to page 2, it's gonna give you the description or it should give you the description.
[CUSTOMER][NEUTRAL] That's what I don't have.
[AGENT][NEUTRAL] You don't have page 2?
[CUSTOMER][NEUTRAL] Only have, yeah, I only have page one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So mine says 1-D280009.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Give me a second.
[AGENT][NEUTRAL] OK, so it says basically says the calendar your maximum for the accident and sickness surgery benefit performed in a hospital.
[AGENT][NEUTRAL] Uh, outpatient facility or freestanding outpatient surgery center has been met for this calendar year, so the maximum benefit is exhausted, so there was no payment on that claim for that reason.
[CUSTOMER][NEUTRAL] And what is um her max? What is the amount, the max amount?
[AGENT][NEUTRAL] I'll give you that.
[AGENT][NEUTRAL] It's $1000 per calendar year.
[CUSTOMER][POSITIVE] OK. All right. Thank you so much for that. Do you guys provide reference numbers?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII]
[AGENT][NEUTRAL] And first initial of my last name is [PII], and did you have any other questions, [PII]?
[CUSTOMER][POSITIVE] That's it. Thank you.
[AGENT][POSITIVE] Alright, you're welcome thanks for calling APL have a good day.
[CUSTOMER][NEUTRAL] Mhm you too bye bye.
[AGENT][NEUTRAL] Bye bye.