AccountId: 011433970860
ContactId: e911d5ff-7d1b-4589-9f38-28d270344dcf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 265920 ms
Total Talk Time (AGENT): 86663 ms
Total Talk Time (CUSTOMER): 84661 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/e911d5ff-7d1b-4589-9f38-28d270344dcf_20250206T13:39_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from provider office and uh looking for uh claim status.
[AGENT][NEUTRAL] OK, can you spell your name for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes. The policy number is
[CUSTOMER][NEUTRAL] 02570169
[AGENT][NEUTRAL] Hold on one moment please.
[AGENT][NEUTRAL] And the patient's name?
[CUSTOMER][NEUTRAL] Name of the patient is.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were needing claim status?
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] OK, I can help you with that one data service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, was it for a
[AGENT][NEUTRAL] What was one of the procedure codes on that bill?
[CUSTOMER][NEUTRAL] Uh, the one was 99214.
[CUSTOMER][NEUTRAL] And another one was 961-27.
[AGENT][NEUTRAL] OK, I found it and.
[AGENT][NEUTRAL] We paid $50 on that office visit.
[CUSTOMER][NEUTRAL] Uh, yeah, and uh the other line 961279.
[CUSTOMER][NEUTRAL] Uh, may I know the reason?
[AGENT][NEUTRAL] Max
[AGENT][NEUTRAL] Max Met, we only pay $50 per office visit.
[AGENT][NEUTRAL] For the whole visit.
[CUSTOMER][NEUTRAL] OK. Uh, so maximum.
[AGENT][NEUTRAL] Right, for the whole visit we pay $50 per office visit, so the max was met when we paid the $50.
[CUSTOMER][NEUTRAL] OK. So $50 is the maximum paid amount uh per date of service, right?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Right, per office visit.
[CUSTOMER][NEUTRAL] For all
[AGENT][NEUTRAL] For the whole visit.
[CUSTOMER][NEUTRAL] OK. And anything that uh left after 50 is applied to our member responsibility or not?
[AGENT][NEUTRAL] Right, whatever is left over will be members responsibility.
[CUSTOMER][NEUTRAL] OK. What I left after, after 50 years member responsibility, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] And uh we can be patient, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Can you provide me your correct mailing address?
[AGENT][NEUTRAL] The claim's mailing address?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And uh timely filing limit.
[AGENT][NEGATIVE] We do not have timely filing.
[CUSTOMER][NEUTRAL] OK. May I know the call reference number?
[AGENT][NEUTRAL] We do not have call reference numbers you can use my name in today's date.
[CUSTOMER][NEUTRAL] Uh, may I know your name one more time?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Thank you so much, Me [PII], for assisting me today. Have a nice.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day as well.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm bye bye