AccountId: 011433970860
ContactId: d5002e73-0a29-442a-ba65-085a7596bbaa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 246970 ms
Total Talk Time (AGENT): 44283 ms
Total Talk Time (CUSTOMER): 86078 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/d5002e73-0a29-442a-ba65-085a7596bbaa_20250616T15:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. Initial to my last name is [PII], and I'm calling for provider alsolo PLLC to check on an additional information about a claim that has been denied. And please note this call will be monitored and recorded for quality and training purposes.
[AGENT][NEUTRAL] May I have a claim number?
[CUSTOMER][NEUTRAL] Sure. The number I have with me is
[CUSTOMER][NEUTRAL] Uh, give me a moment.
[CUSTOMER][NEUTRAL] 3591796.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII]. Can you please spell your name for me?
[AGENT][NEUTRAL] [PII] Last initial is [PII] May I have a good callback number?
[CUSTOMER][NEUTRAL] Sure. It's [PII]. That's a direct line.
[AGENT][POSITIVE] And I have the claim pulled up and how can I help you today?
[CUSTOMER][NEUTRAL] Well, I know.
[CUSTOMER][NEUTRAL] Actually, the claim has been denied, uh, stating the max, uh, max benefit has been reached. So I want to know in the terms of dollars or in the terms of service or in the terms of unit.
[AGENT][NEUTRAL] The Benefit Max allows $75.
[AGENT][NEUTRAL] It was me
[CUSTOMER][POSITIVE] And it has been met, uh, included.
[AGENT][NEUTRAL] Correct, it was met on that first line, 99214.
[CUSTOMER][NEUTRAL] So the remaining balance on the amount of uh for the CPD code 20,550 it's not going to be get paid correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] $75 has been paid for only one code.
[AGENT][NEUTRAL] Correct. This is a hospital indemnity plan. It is a limited benefit plan.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So max benefit has been reached.
[CUSTOMER][NEUTRAL] Can you just give me a moment, [PII]?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Can you just give me a moment?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you just give me a moment. Sorry for the long hold.
[CUSTOMER][POSITIVE] Thank you so much for your patience. Uh, [PII], can I have the call reference number?
[AGENT][NEUTRAL] It will be my name which is Mommy. Last initial is [PII] along with today's date.
[CUSTOMER][POSITIVE] OK, thank you so much. I appreciate your help. That's just a nice day. Thank you.
[AGENT][POSITIVE] You're so welcome.
[AGENT][POSITIVE] Thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] You too. Bye-bye.