AccountId: 011433970860
ContactId: c9cf841f-fcb3-40f0-baef-439487a8d640
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 247639 ms
Total Talk Time (AGENT): 109131 ms
Total Talk Time (CUSTOMER): 81097 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/c9cf841f-fcb3-40f0-baef-439487a8d640_20250514T17:59_UTC.wav
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[AGENT][NEUTRAL] Contacting ATL, my name is Ci[PII]How may I help you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, hi, good afternoon. This is Ma[PII]rom the curators at the University of Missouri. Can you hear me?
[AGENT][NEUTRAL] Oh OK
[AGENT][POSITIVE] Yes, sir. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, thank you, good afternoon. So yes, once again, um I am calling regarding the status of the claim. May I have the claim number if you need it?
[AGENT][NEUTRAL] Uh, yes. What is that claim number, please?
[CUSTOMER][NEUTRAL] Alright, that's gonna be 3582682. Patient is Sc[PII].
[AGENT][NEUTRAL] OK, thank you. And uh is there um
[AGENT][NEUTRAL] Uh, Sc[PII] date of birth, please?
[CUSTOMER][NEUTRAL] Yes, that's gonna be Ma[PII].
[AGENT][NEUTRAL] OK, thank you, and I just need a callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Sure. It's um 80[PII].
[AGENT][NEUTRAL] OK, so you gave me a a thank you. Uh, you gave me a claim number 358282.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Sorry, it's 3582682.
[AGENT][NEUTRAL] OK, let me, let me see if that is not the same.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] They were
[CUSTOMER][NEUTRAL] Hey
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like we received that claim, um.
[AGENT][NEUTRAL] of.
[AGENT][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] I'm trying them.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like we received the claim, uh.
[AGENT][NEUTRAL] what day.
[AGENT][NEUTRAL] On the 27[PII]we process it on the 31[PII].
[AGENT][NEUTRAL] Now it looks like all of the outpatient benefits have been used by that point, um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And so, uh, that's, uh, we, we weren't able to pay that because it looks like all of his outpatient benefits were uh were already paid, so the, so the claim has been processed, um, it's just that the, uh, the benefit we won't pay anything out because he's already used the $3500 for calendar year per calendar year that he had for outpatient benefits.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mm, got it. So if that would be the case, this means that it's gonna be for um the patients since the benefit has already been, um, you know, covered for the calendar year.
[AGENT][NEUTRAL] Well, I
[AGENT][NEUTRAL] Yeah, I I really can't tell you that, but the only thing I can say is, is that is that he's used all the benefits for that. Uh, sometimes they do have, uh, other, um, other policies, but I don't really know, uh, but as, as far as, um, this policy is concerned, he's used all the available benefits for this.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] For this year.
[CUSTOMER][POSITIVE] Got it. OK, I totally understand. Thank you so much for confirming. Um, I'll go ahead and continue working on this account. Uh, by the way, I apologize. May I ask for your name once again, please?
[AGENT][NEUTRAL] Yes, my name is Ci[PII]The first letter of my last name is K [PII]We're gonna use that today's date as our reference. Is there anything else at all that I can help with?
[CUSTOMER][NEUTRAL] Yes, sorry, what's gonna be the reference number?
[AGENT][NEUTRAL] Uh, yes, my name, it's not a reference number, it's my name and that's Ci[PII]n today's date.
[CUSTOMER][NEUTRAL] Oh OK, got it.
[AGENT][NEUTRAL] OK, is there anything else at all that I can help with?
[CUSTOMER][POSITIVE] Alright, have it here with me. Thank you so much for confirming.
[CUSTOMER][POSITIVE] No, Ci[PII]always good. Thank you so much for your assistance.
[AGENT][POSITIVE] Thanks for contacting us. Have a good day.