AccountId: 011433970860
ContactId: dcae9554-fe6f-4822-8fc5-3765bd54b43b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235300 ms
Total Talk Time (AGENT): 85108 ms
Total Talk Time (CUSTOMER): 114020 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/dcae9554-fe6f-4822-8fc5-3765bd54b43b_20250623T17:52_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] calling from provider office to check on a claim.
[AGENT][NEUTRAL] Sure, I can assist you with claims Mr. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh yeah, sure, but before we go ahead, I would like to inform you that this call may be recorded. So is that OK with you?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, OK. Uh, yes, the callback number, it's going to be [PII], and there is an extension [PII].
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from for my notes?
[CUSTOMER][NEUTRAL] Uh yes, facility name is Vital MD Group Holding LLC.
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure. The policy number is going to be
[CUSTOMER][NEUTRAL] 02444813.
[AGENT][NEUTRAL] OK. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Patient name here I have is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you, thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Well, it's for
[CUSTOMER][NEUTRAL] [PII] and the bill amount is $1,053 even.
[AGENT][NEUTRAL] OK. [PII] for $1,053.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and Mr.
[CUSTOMER][NEUTRAL] It's 1,053, yes.
[AGENT][NEUTRAL] OK, Mr. [PII], for future, you can check claim status online through our website at [PII], and that's just optional.
[AGENT][NEUTRAL] And bear with me.
[CUSTOMER][NEUTRAL] Um, yes, thank you for that information. Um, actually, I have a question on this claim. Uh, we received the payment, but, um, there is only $500 we have received. And it says that, uh, with this date of service, patient has met their max benefit up.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I was just calling to check what is the maximum allowed.
[AGENT][NEUTRAL] OK, this policy is one of our secondary supplemental plans to the major medical. This one has a benefit amount of $500 per day.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Um, OK. So, the, whatever the services, it is only allowed $500 right?
[AGENT][NEUTRAL] Yes, it's $500 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And can you also help me with the plan name?
[AGENT][NEUTRAL] This is a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] OK. Um, OK. Thank you so much for this information. And, um, as the primary, like primary applied $783 towards deductible and secondary paid only 500. So, can we go ahead and bill the remaining amount to the patient?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's up to the provider's discretion.
[CUSTOMER][POSITIVE] OK, OK, thank you so much um for all the information and can I have the reference number?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information, Mr. [PII]?
[CUSTOMER][POSITIVE] Uh yeah, sure. That would be a great help if you spell your name for me, please, just to make sure I have the correct one.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Sure. That's [PII].
[CUSTOMER][POSITIVE] OK. OK, thanks so much for that information and that's all from my end. Have a great day. Bye-bye. Take care.
[AGENT][POSITIVE] Yes ma'am. Thank you for calling APL. Have a good day bye bye.
[CUSTOMER][NEUTRAL] Bye.