AccountId: 011433970860
ContactId: f1e39b07-5b48-4baf-a9a0-e3077937d6c4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 433000 ms
Total Talk Time (AGENT): 91687 ms
Total Talk Time (CUSTOMER): 139273 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/f1e39b07-5b48-4baf-a9a0-e3077937d6c4_20250604T18:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, uh [PII]. My first name is [PII]. My last name is [PII] calling you from the provider's office looking for claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Uh yes, the callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And the policy number?
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh yes I uh just uh.
[CUSTOMER][NEUTRAL] Uh, so the patient ID, OK, uh, the member ID start with D as in delta, uh, uh.
[CUSTOMER][NEUTRAL] It belongs to a different department, right?
[AGENT][NEUTRAL] Uh, yes, that's with 90 degree benefits, but we have policies with some of their members. Um, I can look it up by last name.
[CUSTOMER][NEUTRAL] OK, uh.
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] So, the member ID is uh
[CUSTOMER][NEUTRAL] 021-79837.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient's uh date of birth is uh [PII], and the first name is [PII], last name is [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] 718.
[CUSTOMER][NEUTRAL] [PII] total charge is $5,134 even.
[AGENT][NEUTRAL] And it looks like that was received on 2-13-25. Process 213-25.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Uh, outpatient benefit for calendar year has been met dollar amount.
[CUSTOMER][NEUTRAL] OK. So, uh how many uh amounts so you can we build in the amount or in a year?
[AGENT][NEUTRAL] What's the dollar amount for the year?
[CUSTOMER][NEUTRAL] Mhm, yes.
[AGENT][NEUTRAL] 2500.
[CUSTOMER][NEUTRAL] And it's already paid for the full amount 2500.
[AGENT][NEUTRAL] Yes, on previous clients.
[CUSTOMER][NEUTRAL] So, uh, for this claim.
[CUSTOMER][NEUTRAL] The violence is the patient responsibility.
[AGENT][NEUTRAL] We're a secondary policy, so we can't instruct on patient responsibility.
[CUSTOMER][NEUTRAL] OK. Uh, what is the a few times per minute?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] What is the appeal the timely filing event.
[AGENT][NEUTRAL] 180 days from process date.
[CUSTOMER][NEUTRAL] And the uh address.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the uh claim number?
[AGENT][NEUTRAL] The number 3563479.
[CUSTOMER][NEUTRAL] Uh, OK. And also, just, uh, did you receive any abuse?
[AGENT][NEUTRAL] Uh, no, we haven't received any appeals.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, uh, thank you, let's move to the next patient.
[AGENT][NEUTRAL] I.
[CUSTOMER][NEUTRAL] EP society is.
[CUSTOMER][NEUTRAL] Was uh
[CUSTOMER][NEUTRAL] Patients
[CUSTOMER][NEUTRAL] 021-73249.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] The first name is uh [PII]. Last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Date of service and bill charges.
[CUSTOMER][NEUTRAL] [PII] total charges $9,0036 even.
[AGENT][NEUTRAL] It was received on 5-16-25, process 5-19 25.
[AGENT][NEUTRAL] Outpatient benefit for calendar year has been met dollar amount.
[CUSTOMER][NEGATIVE] Uh, same, same denial as the previous one.
[AGENT][NEUTRAL] Yes, dollar amount is calendar year amount is $1500.
[CUSTOMER][NEUTRAL] OK. Uh, thank you. And do you have any call reference number?
[CUSTOMER][NEUTRAL] OK, and how about the claim number for this data?
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] My number is 360-3145.
[AGENT][NEUTRAL] And call reference is my name and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you. That's all I need. Um, have a very blessed day out.
[AGENT][POSITIVE] Thanks for calling APL. You as well. Bye-bye.