AccountId: 011433970860
ContactId: f6d84f19-1385-4274-9596-6b3e1f59bd30
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326010 ms
Total Talk Time (AGENT): 114774 ms
Total Talk Time (CUSTOMER): 108322 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/f6d84f19-1385-4274-9596-6b3e1f59bd30_20250207T21:26_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Initial of my last name, [PII] calling from provider's office for please. Can I have your name and initial of your last name, please?
[AGENT][NEUTRAL] It's [PII], first initial last name is [PII], how do you spell your first name?
[CUSTOMER][NEUTRAL] It is [PII], initial of my last name, [PII].
[AGENT][NEUTRAL] And my
[AGENT][NEUTRAL] Oh, [PII]. OK. How can I help you today?
[CUSTOMER][NEUTRAL] Uh, I'm calling for claim status. Could you please help me with that?
[AGENT][NEUTRAL] I can. What's the policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 02032964.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] It is [PII] and it is direct line.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. The date of birth is [PII].
[AGENT][POSITIVE] Thank you for that information and we're checking claim status, right?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] For what date of service?
[CUSTOMER][NEUTRAL] The date of service is [PII]. Charge amount is $130 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Showing this claim was received [PII] processed [PII] and it looks like the benefits were applied towards the.
[AGENT][NEUTRAL] Um, calendar your deductible, so 1:30 was applied towards deductible amount under this policy.
[CUSTOMER][NEUTRAL] And may I have the claim number?
[AGENT][NEUTRAL] It's 349-326-9.
[AGENT][NEUTRAL] And did you have any other questions, [PII]?
[CUSTOMER][NEUTRAL] Uh yes. Uh, is it applied towards in-network deductible or out-network deductible?
[AGENT][NEUTRAL] It's not an in or out it's just one deductible under this plan.
[CUSTOMER][NEUTRAL] OK. And
[CUSTOMER][NEUTRAL] May I know the annual deductible?
[AGENT][NEUTRAL] $2000 per calendar year.
[CUSTOMER][NEUTRAL] $2000. And how was they met yet?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You said this is a 2024 claim, so so far, um, the patient has only satisfied 215 of that 2000.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] 215.
[AGENT][NEUTRAL] Dollars of the $2000 maximum is met so far for year 24.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No sure.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And I have the one more with me for the same patient.
[AGENT][NEUTRAL] Same person or different patient.
[CUSTOMER][NEUTRAL] Same patient.
[AGENT][NEUTRAL] Data service?
[CUSTOMER][NEUTRAL] 722 2024.
[CUSTOMER][NEUTRAL] Charge amount is $560 even.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Same, uh, the $85 was applied towards the deductible.
[CUSTOMER][NEUTRAL] May I have the received date process date?
[AGENT][NEUTRAL] Received [PII], processed [PII].
[CUSTOMER][NEUTRAL] May I have the claim number?
[AGENT][NEUTRAL] Claim number is 3493272.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] Sorry, could you repeat that one?
[AGENT][NEUTRAL] Can you
[AGENT][NEUTRAL] 349
[AGENT][NEUTRAL] 3272.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can also check status of your claim online at [PII] and Mary, did you have any other questions?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, and $85 is applied to a deductible, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And could you please help me with a copy of EOB for both claims?
[AGENT][NEUTRAL] OK, so they both ELBs were mailed uh on the [PII], the day after they were processed and are now available to download on our online service center. Let me know when you're ready and I'll give you that web address.
[CUSTOMER][NEUTRAL] Uh, yes, allow me a minute.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh yes. Go ahead.
[AGENT][POSITIVE] Uh, [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much. And may I have your call reference?
[AGENT][NEUTRAL] My name in today's date.
[CUSTOMER][POSITIVE] Thank you so much for your help. I hope you have a wonderful day ahead and stay safe.
[AGENT][POSITIVE] And you're welcome [PII] and thank you for calling APL. Have a good day as well.
[CUSTOMER][POSITIVE] You have a good day. OK.
[AGENT][NEUTRAL] Mhm.