AccountId: 011433970860
ContactId: d9d42da7-dd38-45bc-b4af-ad8acba1158f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219759 ms
Total Talk Time (AGENT): 97116 ms
Total Talk Time (CUSTOMER): 70226 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/d9d42da7-dd38-45bc-b4af-ad8acba1158f_20250422T19:40_UTC.wav
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[AGENT][NEUTRAL] Contacting APR. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII] and I'm calling from a provider's office. Can you check to see if you have a claim on file?
[AGENT][NEUTRAL] Yes, I can certainly uh check a claim. Do you. What is that policy number, please?
[CUSTOMER][NEUTRAL] 01749782
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Um, [PII], uh, [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yeah [PII].
[AGENT][NEUTRAL] Thank you. What data service are we looking for for [PII]?
[CUSTOMER][NEUTRAL] Um, it's for [PII].
[AGENT][NEUTRAL] OK, is there a particular build amount that I should look for?
[CUSTOMER][NEUTRAL] Um, the total bill amount was 260.
[CUSTOMER][NEUTRAL] Dollars but it looks like primary paid all but 5852.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, let me just check here.
[AGENT][NEUTRAL] Just a second here.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK, it looks like the claim number on this.
[AGENT][NEUTRAL] It's 347.
[AGENT][NEUTRAL] 092 8. So that's 347.
[AGENT][NEUTRAL] 0928.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it looks like that was processed.
[AGENT][NEUTRAL] We received the claim on the [PII], and we processed it on the [PII].
[AGENT][NEUTRAL] [PII]. Now there was a benefit that uh would, would have been paid $4.62 excuse me, $4.52.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But the policy um has a $1000 deductible that must be met before anything will be paid out. And so that's where the the benefit went was to the uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, to the deductible for this account.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I can, I can send you a copy.
[CUSTOMER][NEUTRAL] So you're saying of the uh oh I'm sorry, go ahead.
[AGENT][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] Well I can send you a copy of the EOB um if you don't have it, but uh that's what happened to the benefit of it.
[CUSTOMER][NEUTRAL] So this who is the payment issued to does it go to the subscriber or?
[AGENT][NEGATIVE] No, it, what it does is there is no payment. Um, it, what it does is it, it goes straight to the, to the, um, uh, to the deductible that was, uh, for this plan. So there, so there is no payment.
[CUSTOMER][NEUTRAL] 00.
[CUSTOMER][NEUTRAL] Oh, OK, so did the whole like 5852 go to deductible? Is that how that goes?
[AGENT][NEUTRAL] Yes, everything went to the deductible.
[CUSTOMER][NEUTRAL] Since that was the remaining.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, I got it. Alright, OK, OK. No, I don't need it, uh, an, an explanation of benefits. I'll just go ahead and document this information. Um, do you need the reference numbers for phone calls?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII], and we're gonna use that today's date as a reference. [PII], is there anything else at all that I can help with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, I think I'm good thank you so much.
[AGENT][POSITIVE] OK, thanks for contacting A