AccountId: 011433970860
ContactId: e2aafa5d-18ef-46c0-bc8a-53ceddbed862
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286140 ms
Total Talk Time (AGENT): 80416 ms
Total Talk Time (CUSTOMER): 95629 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/e2aafa5d-18ef-46c0-bc8a-53ceddbed862_20250114T19:19_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII] and I'm calling from the provider's office calling in to check members um claims status.
[AGENT][NEUTRAL] OK, I can help you with claim status. And did you say your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And then in case this call is disconnected, may I have your callback number?
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] The callback number is.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] The patients.
[CUSTOMER][NEUTRAL] ID is.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It is 021-68401.
[AGENT][NEUTRAL] Thank you, and that was 02168401?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you. And may I have the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The member's name is?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] And may I have the date of service and the billed amount of the claim?
[CUSTOMER][NEUTRAL] Um, the that service is for [PII].
[CUSTOMER][NEUTRAL] Of [PII].
[CUSTOMER][NEUTRAL] And the bill amount is 1200.
[AGENT][NEUTRAL] Thank you. So it's for data services of [PII] for $1200.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, I show that claim was received on [PII] and processed on [PII].
[AGENT][NEUTRAL] Benefits for this data service has already been met, therefore, no benefits are payable. The max has already been met for this data service. Would you like the claim number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 3407857
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] May, may I know when was this um services made and how many times did this um is this service allowed?
[AGENT][NEGATIVE] They've met their max for this particular data service. They have no more benefits available for that data service. They've met their max.
[CUSTOMER][NEUTRAL] Um, so can I bill this one to the patient?
[AGENT][NEUTRAL] We don't have any involvement in your handling of any remaining claim amounts, that's up to your determination.
[CUSTOMER][NEUTRAL] Got it. And do you see any other insurance on file for the patient?
[AGENT][NEUTRAL] There's no other coverage.
[CUSTOMER][NEUTRAL] And just for my information, is the member, can I get the member's eligibility?
[AGENT][NEUTRAL] Effective [PII].
[CUSTOMER][NEUTRAL] Oh, OK, got it.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][NEUTRAL] You're welcome. Is there anything else I can assist you with today, [PII]? It'll be just my name, that's [PII] spelled [PII]
[CUSTOMER][NEUTRAL] Uh, may I get a call reference number?
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Got it, thank you so much.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. You have a good day.
[CUSTOMER][POSITIVE] Thank you you as well bye bye.
[AGENT][POSITIVE] You're welcome. Thanks, bye.