AccountId: 011433970860
ContactId: d736fc6a-a0c9-47fd-9704-fa268e31171e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250429 ms
Total Talk Time (AGENT): 88109 ms
Total Talk Time (CUSTOMER): 86420 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/d736fc6a-a0c9-47fd-9704-fa268e31171e_20250613T16:53_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII]. Last name for essential care and I'm calling from provider office to check on the claim status. Can you have the status of the claim?
[AGENT][NEUTRAL] Sure, I can verify claim status for you. And [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Uh, it's 024733.
[CUSTOMER][NEUTRAL] 73 M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] OK, it's [PII]. It's a direct line, no extension.
[AGENT][NEUTRAL] OK, and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Patient's name, it's uh [PII].
[CUSTOMER][NEUTRAL] [PII] and the date of birth would be [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] The service would be 200, sorry.
[CUSTOMER][NEUTRAL] Data service, it's uh [PII]. The charges will be $1,952 even, $1952 even.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, and what was the balance after Primary Assurance has processed the claim?
[CUSTOMER][NEUTRAL] It's uh $1,126 even.
[AGENT][NEUTRAL] OK, give me one moment please.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][POSITIVE] Yeah, ma'am, actually, I want you.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] I'm from Saint Lucie Anesthesia Associates LLC.
[AGENT][NEUTRAL] OK, uh, thank you. I'm showing that claim processes the benefits of Max for the data service.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] The claim processed as the benefits have maxed for the data of service.
[CUSTOMER][NEUTRAL] And it's matched the date of service.
[AGENT][POSITIVE] Correct, the benefits have maxed for the date of service.
[CUSTOMER][NEUTRAL] Um, can you explain why and what is that exactly?
[AGENT][NEUTRAL] That means that the patient, the patient has a max benefit that's paid per day, and for that data service of [PII], they've already met that max benefit. So there's no more benefits that is payable.
[CUSTOMER][NEUTRAL] OK. Oh.
[CUSTOMER][NEUTRAL] OK. How much, how much, how much is it is?
[AGENT][NEUTRAL] Uh, the patient has a benefit max up to $300 per calendar day.
[CUSTOMER][NEUTRAL] $300 for the date of surgery.
[AGENT][NEUTRAL] Per day
[CUSTOMER][NEUTRAL] OK, for a day for only $300 even.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, thank you. And uh, can you provide me the claim number?
[AGENT][NEUTRAL] Sure, 3609014.
[CUSTOMER][POSITIVE] I have a good time?
[AGENT][NEUTRAL] It's [PII], last initial Q as [PII].
[CUSTOMER][NEUTRAL] OK, and the patient plan right?
[AGENT][NEUTRAL] It is a policy, it's a secondary supplemental plan.
[CUSTOMER][NEUTRAL] I get 2 more people.
[AGENT][NEUTRAL] It's a secondary supplemental policy.
[CUSTOMER][NEUTRAL] to the
[CUSTOMER][NEUTRAL] And uh call the fish.
[AGENT][NEUTRAL] You may use my name in today's date.
[CUSTOMER][POSITIVE] OK. Thank you, ma'am. Have a nice day. Take care. Happy weekend.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Bye.