AccountId: 011433970860
ContactId: c63a586c-e021-4a36-a05b-afaf5266d0e1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 197050 ms
Total Talk Time (AGENT): 54728 ms
Total Talk Time (CUSTOMER): 78647 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/c63a586c-e021-4a36-a05b-afaf5266d0e1_20250103T17:14_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hello, good morning. It's [PII] calling from provider's office to check on the claim status.
[AGENT][POSITIVE] I'd be happy to assist with claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Sure, it's [PII] and it's a direct line.
[AGENT][NEUTRAL] OK, and what is the policy number?
[CUSTOMER][NEUTRAL] It's 01070755. It's for [PII].
[AGENT][NEUTRAL] Patient's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that information and the date of service for the claim?
[CUSTOMER][NEUTRAL] Mm, it's [PII] for the total charge amount of $535 even.
[AGENT][NEUTRAL] What is your tax ID?
[CUSTOMER][NEUTRAL] The tax ID would be [PII].
[AGENT][NEUTRAL] OK, thank you for that. I'm showing that we made a payment of $25.
[AGENT][NEUTRAL] On that claim, that was the maximum for an office visit.
[CUSTOMER][NEUTRAL] OK. And um what about the second code that is 1005?
[AGENT][NEGATIVE] That was denied.
[CUSTOMER][NEUTRAL] OK, so could you please provide me with the denied reason.
[AGENT][NEUTRAL] The maximum benefit is $25 and we have paid the $25 on the other CPT code, the [PII], I believe.
[CUSTOMER][NEUTRAL] OK, so the maximum benefit.
[CUSTOMER][NEUTRAL] It's $25.
[CUSTOMER][NEUTRAL] And that is paid for the office visit code, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, so, um,
[CUSTOMER][NEUTRAL] The remaining amount would be patient responsibility or something else?
[AGENT][POSITIVE] That's correct, patient responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So could you please help me out if you know like if there is any patient responsibility, like how much amount would be the patient responsible.
[AGENT][NEUTRAL] Well, we don't determine, we don't determine the patient responsibility. That would be up to you to determine the patient responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, fine, that's great. uh, could you please help me out with the caller.
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I can assist with today?
[CUSTOMER][POSITIVE] No, thank you so much, [PII].
[AGENT][POSITIVE] Thank you for calling ATL. Have a good day.
[CUSTOMER][POSITIVE] You have a great day.