AccountId: 011433970860
ContactId: c897492b-e97e-498b-b544-170fc45de25d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 420549 ms
Total Talk Time (AGENT): 127013 ms
Total Talk Time (CUSTOMER): 66331 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/c897492b-e97e-498b-b544-170fc45de25d_20250527T18:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm [PII] calling from provider's office for checking on a claim.
[AGENT][NEUTRAL] I can help you with claim status. [PII]. Can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and do you have the policy number with you?
[CUSTOMER][NEUTRAL] Policy number.
[CUSTOMER][NEUTRAL] It is 025.
[CUSTOMER][NEUTRAL] 671-72.
[AGENT][NEUTRAL] OK one moment while I look that up.
[AGENT][NEUTRAL] And can I get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's a few blum.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] Yeah I have data service.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The bill amount is $370 even.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, it looks like we received that claim on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 3556006.
[CUSTOMER][NEUTRAL] You said 3556006, right?
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it looks like we paid $50 towards that claim.
[CUSTOMER][NEUTRAL] OK, $50.
[CUSTOMER][NEUTRAL] What are the remaining payment which is $320.
[AGENT][NEUTRAL] Um, I don't know patient responsibility, but with that $50 the maximum benefit payable for that date of service was met. Um, so that's all we were able to pay. We, we don't, uh, determine patient responsibility.
[CUSTOMER][NEUTRAL] Yeah, I'm asking what would the.
[CUSTOMER][NEUTRAL] $320.
[AGENT][NEUTRAL] Right, that would be the leftover amount. We only paid 50.
[CUSTOMER][NEUTRAL] OK, it's a providers right off, right.
[AGENT][NEUTRAL] Yes, it was paid to the provider.
[CUSTOMER][NEUTRAL] Uh, it is a providers right off, right? $320.
[AGENT][NEUTRAL] Um, I don't know where that amount, um, if it went back to the patient or if it went back to the hospital, we don't determine that, we just pay the benefit towards it.
[AGENT][NEUTRAL] I don't know where the $320 who's taking care of that?
[AGENT][NEGATIVE] It was not covered for this policy.
[CUSTOMER][NEUTRAL] It is not a patient responsibility as well, right?
[AGENT][NEUTRAL] We don't determine patient responsibility it's up to the provider.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] Could you spell your name please?
[AGENT][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Last initial, [PII].
[CUSTOMER][NEUTRAL] And call reference number.
[AGENT][NEUTRAL] We don't have call reference numbers, but you can use my name and last initial in today's date.
[CUSTOMER][NEUTRAL] Could you please fax me the EOP?
[AGENT][NEUTRAL] Do you have a good fax number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It's 847.
[AGENT][NEUTRAL] 847.
[CUSTOMER][NEUTRAL] 706.
[CUSTOMER][NEUTRAL] 706.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1838.
[AGENT][NEUTRAL] Alright, and let me verify that with you. I have 847.
[AGENT][NEUTRAL] 706-1838 correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right. Give me just a moment.
[AGENT][NEUTRAL] Let me pull it up and get ready to fax it to you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I just sent a fax of the primary EOB. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Well thank you.
[AGENT][POSITIVE] Great, thank you for calling APL and have a great day.