AccountId: 011433970860
ContactId: f1081927-9988-4b05-9854-1d35c0d79a89
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 148199 ms
Total Talk Time (AGENT): 48432 ms
Total Talk Time (CUSTOMER): 66414 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/f1081927-9988-4b05-9854-1d35c0d79a89_20250612T13:45_UTC.wav
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[AGENT][NEUTRAL] For calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII] calling from provider office check claim status.
[AGENT][NEUTRAL] Can I get a callback number?
[CUSTOMER][NEUTRAL] The callback number is [PII] and it's a direct line.
[AGENT][NEUTRAL] Can I get the policy number you're calling on?
[CUSTOMER][NEUTRAL] The policy number that could be 024.
[CUSTOMER][NEUTRAL] 97465
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying the policy and you said status today. What is the date of service you're checking?
[CUSTOMER][NEGATIVE] The service is [PII] and the bill value was $430 even. Uh, actually, I have got an EOB.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I look, I have a specific concern in this claim.
[AGENT][NEUTRAL] So the claim was denied. Um, the policy allows up to $500 per day, uh, and the daily max had been met prior to your, your claim. So your claim was denied.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Daily Max Mitt for the day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] As for the patient plan, it's only $500. It will be allowed in a day, which is already made. So we can be able to bring this claim to the, to the patient.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] That is up to the provider. We do not determine patient responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it's terms of the dollar value, it's going to be denied, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, not an issue. Mm.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK, then that's it from my side.
[CUSTOMER][NEUTRAL] Uh, no, that's it from my side. Please help me a call reference number.
[AGENT][NEUTRAL] To reference the call, you will use my name [PII] and today's date.
[CUSTOMER][POSITIVE] OK, fine. OK, then that's it from my side. Thank you. Thank you for great assistance. Have a nice day. Bye-bye.
[AGENT][POSITIVE] You're welcome, [PII]. You have a wonderful day. Thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Same to you. Bye bye.