AccountId: 011433970860
ContactId: d98aa79a-bae0-4e9c-b3f8-c26a3b033852
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 400869 ms
Total Talk Time (AGENT): 99690 ms
Total Talk Time (CUSTOMER): 85618 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/d98aa79a-bae0-4e9c-b3f8-c26a3b033852_20250422T14:50_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah. Hi, my name is [PII] calling from provider office to check on claims.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with um claim status. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah, callback number is [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Yeah, the policy number is 021-91897.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yeah, the patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Um, now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII] with the bill amount of $90.59.
[AGENT][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] OK. Yes, ma'am. We received that claim on.
[AGENT][NEUTRAL] One moment, I'm waiting for the date to come up.
[AGENT][NEUTRAL] OK, we received that claim on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 3502273.
[AGENT][NEUTRAL] And this claim denied because the annual benefit maximum was reached on a previous claim.
[CUSTOMER][NEUTRAL] Uh, it's denied for maximum benefit existing.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, yeah. May I know, it is, uh,
[CUSTOMER][NEUTRAL] This, uh, how many visits are allowed?
[AGENT][NEUTRAL] He's allowed 6.
[AGENT][NEUTRAL] Per calendar year.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] May I know uh
[CUSTOMER][NEUTRAL] Which was the last uh visit?
[CUSTOMER][NEUTRAL] The date, may I know the date?
[AGENT][NEUTRAL] Yes, ma'am. Let me get to that one moment.
[AGENT][NEUTRAL] OK, it was met on [PII].
[CUSTOMER][NEUTRAL] Could you please repeat again?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I get the date of the 66 times per year you stated, right? This is the first date. Uh, again, may I get the last 5 dates which was presented?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK. The first one was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The second one was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The third one was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then there was another one on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then [PII], well.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, this is the 6 times in a calendar year, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] The last.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, may I get your name?
[AGENT][NEUTRAL] My name is [PII]. It's spelled [PII] My last initial is [PII], and my name and today's date will be your reference number. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that's it. Thank you for your assistance. Have a great day. Bye-bye.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Bye.