AccountId: 011433970860
ContactId: cc90365a-4c8d-4d4f-af00-3d9f4d1def86
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 411739 ms
Total Talk Time (AGENT): 160299 ms
Total Talk Time (CUSTOMER): 109493 ms
Interruptions: 2
Overall Sentiment: AGENT=1.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/cc90365a-4c8d-4d4f-af00-3d9f4d1def86_20250422T19:36_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey this is [PII] at Affordable Employee Benefits.
[AGENT][POSITIVE] Hi, Ms. [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] I am calling. Let me get her routing number just.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I see [PII].
[CUSTOMER][NEUTRAL] Her ID number.
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] OK. And Miss [PII] mhm.
[CUSTOMER][NEUTRAL] And I just had a question to see if you had a claim on file or not.
[AGENT][NEUTRAL] OK, I can help you with claim status. May I get your callback number, Ms. [PII], just in case the call gets dropped? I'll be able to call you right back.
[CUSTOMER][NEUTRAL] Yeah, it's uh it's number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you so much. And then um what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, her name is [PII].
[CUSTOMER][NEUTRAL] And let me get some info.
[CUSTOMER][NEUTRAL] I have her address. Let me pull it back up on.
[CUSTOMER][NEUTRAL] Birthday to start.
[CUSTOMER][NEUTRAL] Clinic for Women.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Can I give you her address?
[AGENT][POSITIVE] Yes, that'll be fine.
[CUSTOMER][NEUTRAL] Alright, [PII].
[AGENT][POSITIVE] Thank you so much. And then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] Alright, so today was [PII].
[CUSTOMER][NEUTRAL] And it's from Baptist Memorial Hospital.
[CUSTOMER][NEUTRAL] And the total I have is 30,63346.
[CUSTOMER][NEUTRAL] That would have been before primary insurance.
[AGENT][NEUTRAL] OK, and
[AGENT][NEUTRAL] OK, and then what is the balance after the primary insurance paid?
[CUSTOMER][NEUTRAL] Um, I don't have that. All I have was a total, so they gave me was the total charge.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, alright, I'll try to go and find it with this total. I'm gonna put you on a brief, uh huh.
[CUSTOMER][NEUTRAL] They said that they thought that American public get paid.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] But they wouldn't sure so I just want to verify.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, all right. It's gonna be a brief hold while I look up this claim for us, Ms. [PII], and I'll be right back with you in just a sec. Thank you, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]. You are on hold.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Going to [PII]'s. All right, I love you, be careful.
[AGENT][POSITIVE] Thank you for the food.
[AGENT][NEUTRAL] Yeah that's what I'm gonna eat for dinner tonight.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you so much for holding for me, Ms. [PII]. You are correct. Uh, that claim was paid. Let me give you the total and the check number. It was paid $2,464.07.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] With check number 1832906 and let me see if there's any remarks.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it does say that part of the payable benefits were applied to the policy deductible of $100.
[AGENT][NEUTRAL] And then let me check and see if that check has been cashed yet.
[CUSTOMER][NEUTRAL] Sure it's been a year.
[AGENT][NEUTRAL] Yes ma'am, it was, it was, it was cleared on [PII].
[CUSTOMER][POSITIVE] I think she got it.
[CUSTOMER][NEUTRAL] OK, so was it just the balance of 100 or was there like coinsurance and stuff?
[AGENT][NEUTRAL] No, the check paid $2,464.07. So with this policy,
[CUSTOMER][NEUTRAL] So that just lists.
[AGENT][NEUTRAL] Um, it's a limited, it's um.
[AGENT][NEUTRAL] A supplemental policy that helps with deductible co-insurance and co-pays and they have
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this is just a verified benefits it's not a guarantee of payment. They have a um outpatient benefit amount.
[AGENT][NEUTRAL] Of $2800 per calendar year. So after that amount was paid $100 went towards the deductible.
[AGENT][NEUTRAL] And then the benefits were exhausted for the calendar year.
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][POSITIVE] OK, got you. OK, well, that's what I needed to know. Thank you.
[AGENT][POSITIVE] You're so welcome. um anything else, Miss [PII] I can help you with before we go?
[CUSTOMER][NEUTRAL] That is all I got for now.
[AGENT][POSITIVE] OK, well, you have a great rest of your week and thank you for calling APL.
[CUSTOMER][POSITIVE] Alright you too thank you.
[AGENT][POSITIVE] Bye-bye. You're welcome.