AccountId: 011433970860
ContactId: e63a0af4-0ba2-40a0-9197-78b211c65018
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 149600 ms
Total Talk Time (AGENT): 37891 ms
Total Talk Time (CUSTOMER): 59636 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/e63a0af4-0ba2-40a0-9197-78b211c65018_20250203T20:51_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from Multi-are Health System, and I'm calling to check on the status of a medical claim.
[AGENT][POSITIVE] I'll be happy to assist with the claim today and if I can get a good callback number for you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] 02557080.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] And the date of service for the claim?
[CUSTOMER][NEUTRAL] Is [PII] for $449.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Thank you for that information. So I'm showing we received the claim twice. On the first time of payment, uh, was made in the amount of $50 and the second time it denied as a duplicate.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right, OK, so the, is this, we did receive the payment of $50.
[CUSTOMER][NEUTRAL] Is what the EOB just says it paid 50 but it doesn't say anything else that was for an office visit.
[CUSTOMER][NEUTRAL] Is that the max you pay and is there a discount or is the remaining balance patient responsibility?
[AGENT][NEUTRAL] That is the maximum that we pay and the remaining is patient responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, let's see, do I have, I do have a claim number, OK, and then do you use reference numbers?
[AGENT][NEUTRAL] The reference would just be my name [PII] last initial S as in Sam, and the date and time of the call. Was there anything else that I could assist with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That will do it. Thank you so much for your help.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye bye.
[AGENT][NEUTRAL] Mhm. Bye-bye.