AccountId: 011433970860
ContactId: c92bd408-471e-46bf-a012-bc65d174586c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226929 ms
Total Talk Time (AGENT): 76553 ms
Total Talk Time (CUSTOMER): 86495 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/c92bd408-471e-46bf-a012-bc65d174586c_20250624T14:53_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling from Pros office to check on your claim clarifications.
[AGENT][NEUTRAL] I'm sorry, I could barely hear you. Can you repeat that for me please?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling from provider's office to check on your client status.
[AGENT][POSITIVE] I'd be happy to assist with client status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII] and the extension is [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] The policy number is
[CUSTOMER][NEUTRAL] 0261.
[CUSTOMER][NEUTRAL] 1291.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] And your tax ID.
[CUSTOMER][NEUTRAL] And the tax ID number is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that information, um, and the date of service?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] Thank you for that. I'm showing that um we paid the maximum which was $50.
[CUSTOMER][NEUTRAL] OK, but we build the claim for $2,174.95. So what about the remaining balance?
[AGENT][NEUTRAL] Based on their policy.
[AGENT][NEUTRAL] Based on their policy, the maximum payable is $50.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So you'll need to build the um patient for the rest.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, so may I know that each CPT code allowed on beta mode?
[AGENT][NEUTRAL] We don't do an allowed amount. They have a this is a limited benefit hospital indemnity plan. They have a fixed dollar benefit amount which is $50 so that's all we paid. That was the maximum payable for this ER visit and that's what we paid.
[CUSTOMER][NEUTRAL] OK, could you please, uh, elaborate with that the CPT code we built for?
[AGENT][NEUTRAL] I'm sorry, I don't understand.
[CUSTOMER][NEUTRAL] Uh, I mean, uh, could you please explain about that, uh, each CPT code? How much do you pay for that each CPT code?
[AGENT][NEUTRAL] And we just pay $50. You can apply to any CPT code you want. We just pay $50. That was their maximum benefit.
[CUSTOMER][NEUTRAL] OK, so the remaining balance is a patient responsibility, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] May I know the uh members plan name?
[AGENT][NEUTRAL] Um, it's
[AGENT][NEGATIVE] American public life, I don't understand.
[AGENT][NEUTRAL] It's a hospital indemnity plan.
[CUSTOMER][NEUTRAL] I mean, uh, that any specific.
[AGENT][NEUTRAL] It doesn't have a name. It's a hospital indemnity plan.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, thank you so much for this information. Could you please spell out your name?
[AGENT][NEUTRAL] It's [PII] [PII]. Was there anything else I could assist with today?
[CUSTOMER][POSITIVE] Uh, no, [PII]. So thank you so much for assistance. Have a great day.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Right