AccountId: 011433970860
ContactId: c835f0d3-98fc-4f4e-8738-73fe3ebbb715
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 889849 ms
Total Talk Time (AGENT): 253231 ms
Total Talk Time (CUSTOMER): 160759 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/c835f0d3-98fc-4f4e-8738-73fe3ebbb715_20250409T14:23_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Can you please help me with the charges?
[AGENT][POSITIVE] Mm, sure, yes, I can assist you with.
[AGENT][NEUTRAL] And may I have your name?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[AGENT][NEUTRAL] OK. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 018287774.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh, so.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you. And what's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Um, services, uh, [PII].
[CUSTOMER][NEUTRAL] And the build mountains.
[CUSTOMER][NEUTRAL] It's 179.64.
[AGENT][NEUTRAL] OK, let me see if I can find this claim for you. And for the future, you can check claim status online through our website at [PII].
[AGENT][NEUTRAL] And one moment.
[CUSTOMER][NEUTRAL] Uh, can you please spell your name?
[AGENT][NEUTRAL] Sure, my name is [PII].
[AGENT][NEUTRAL] Let me look at this one.
[AGENT][NEUTRAL] I'm still waiting on the system, bear with me.
[AGENT][NEUTRAL] OK, so it looks like we processed the claim on [PII] and um it looks like the benefits has been applied towards the 1000 calendar year deductible.
[CUSTOMER][NEUTRAL] What's the deductible amount?
[AGENT][NEUTRAL] The 1000 calendar year deductible on the amount that was supplied to that amount was $138.19.
[CUSTOMER][NEUTRAL] What's the member annual deductible amount?
[AGENT][NEUTRAL] 1000.
[CUSTOMER][NEUTRAL] What's the max amount.
[AGENT][NEUTRAL] 1000.
[CUSTOMER][NEUTRAL] It's fully met right?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] At about $1000 and the annual deductible also the $1000.
[AGENT][NEUTRAL] No, I'm not understanding. OK. The calendar year maximum or the deductible amount, the calendar year deductible amount is 1000.
[CUSTOMER][NEUTRAL] How much is the next amount?
[AGENT][NEUTRAL] The maximum benefit amount. OK, bear with me just a second.
[CUSTOMER][NEUTRAL] Met, but, wait a minute. No, I want to know the net amount. How much the net amount.
[AGENT][NEUTRAL] The net amount, how much has it been met from that deductible?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Bear with me, I'll have to get this together. One moment.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] He has met $208.19.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What's the claim number?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, the claim number is 356-877-0.
[CUSTOMER][NEUTRAL] What's allowed.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I have to check the major medical AOB one moment because we don't have that information on the EOB. We are the secondary policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] OK, based on the information received with the claim from the major medical, United Healthcare, um, they have uh put $138.19 towards the deductible.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] I have the next number.
[AGENT][NEUTRAL] Do you need any other information on this one, Miss [PII]?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] How was it?
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have the next member.
[AGENT][NEUTRAL] OK, bear with me. Do you need any other information on this or Miss [PII]?
[AGENT][NEUTRAL] [PII], can you hear me? I think we're having troubles with the hearing because uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Do you need any other information on this one?
[CUSTOMER][NEUTRAL] Can I tell you the
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEGATIVE] No, no.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] What's the next policy number?
[CUSTOMER][NEUTRAL] It's uh 01721477.
[AGENT][NEUTRAL] Repeat that number one more time.
[CUSTOMER][NEUTRAL] 01721477.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, um, you sound like far away. It's like you come close and then you're far away and then you're close and then you're far away. Can you repeat the date of birth? I didn't get that.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] On [PII].
[AGENT][NEUTRAL] How much is the total charge?
[CUSTOMER][NEUTRAL] The.
[CUSTOMER][NEUTRAL] Uh, $120 even.
[AGENT][NEUTRAL] That was [PII] for 120.
[CUSTOMER][NEUTRAL] Oh yes.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] I don't have a claim for [PII].
[CUSTOMER][NEUTRAL] OK. Uh, what's the mailing address?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] What's the uh policy active date?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. Our policy effective date is [PII] and it is active at the moment.
[CUSTOMER][NEUTRAL] But it's only 5 years.
[AGENT][NEGATIVE] There's no timely filing limits.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I the one more day to service.
[AGENT][NEUTRAL] A different member or same member?
[CUSTOMER][NEUTRAL] Same number.
[AGENT][NEUTRAL] OK, what's the date of service?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, we don't have a claim on file for that date of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] I have next number.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] And the next member.
[AGENT][NEUTRAL] Oh, you have another member?
[AGENT][NEUTRAL] Um, how many more claims do you have, Miss [PII]?
[CUSTOMER][NEUTRAL] last
[AGENT][NEUTRAL] I'm sorry, can you repeat?
[CUSTOMER][NEGATIVE] That will be lost.
[AGENT][NEUTRAL] Oh OK one moment.
[AGENT][NEUTRAL] Let me make a note on this one and you don't need any other information on this one. Bear with me just a second.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] And.
[AGENT][NEUTRAL] 4.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, what's the next policy number?
[CUSTOMER][NEUTRAL] T. 43219963.
[AGENT][NEUTRAL] Do you see a policy certificate number? It's gonna start with the 0 followed by 7 digits like the ones prior.
[CUSTOMER][NEUTRAL] No, it's uh D Delta 43219962.
[AGENT][NEUTRAL] Yeah, that's not our number.
[CUSTOMER][POSITIVE] Thank you for telling me to call this number.
[AGENT][NEUTRAL] Do you have a special?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Tell me the call reference number please.
[AGENT][NEUTRAL] And we don't have a reference numbers. You can use my name in today's date if you would like, Miss [PII].
[CUSTOMER][NEUTRAL] OK bye bye.
[AGENT][NEUTRAL] Is there anything else I may help you with today?