AccountId: 011433970860
ContactId: faf0f5fa-5e5b-4129-bf7a-c81610e93db7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 374730 ms
Total Talk Time (AGENT): 103715 ms
Total Talk Time (CUSTOMER): 104970 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/faf0f5fa-5e5b-4129-bf7a-c81610e93db7_20250214T21:04_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] speaking from the provider's office to check the claim status.
[AGENT][NEUTRAL] I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] 02443351.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient's name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Alrighty, and we're checking claim status for what data service?
[CUSTOMER][NEUTRAL] This [PII].
[AGENT][NEUTRAL] And what's the total charge?
[CUSTOMER][NEUTRAL] One minute.
[CUSTOMER][NEUTRAL] 108601.00.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And so is this a range of dates?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I show that this claim was processed well received on December, I mean [PII], processed on [PII].
[CUSTOMER][NEUTRAL] Hello
[AGENT][NEUTRAL] 25 and it looks like.
[AGENT][NEUTRAL] $150 was applied towards the deductible under this policy.
[CUSTOMER][NEUTRAL] and 50 years applied to a deductible.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And was the allowed amount the same?
[AGENT][NEUTRAL] I don't the allowed amount is gonna be on the primary ELB that was sent with the claim.
[AGENT][NEUTRAL] So you'll have to look at that document for the allowed amount.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] So the amount which was transferred was $150 and $150 has been applied towards deductible, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] On. And what was the annual deductible amount for the patient?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The calendar your deductible is.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] All right, the calendar, your deductible for this plan.
[AGENT][NEUTRAL] Is um up to 1500 per covered person per calendar year.
[CUSTOMER][NEUTRAL] It's 1500. And what was the net amount?
[AGENT][NEUTRAL] Currently,
[AGENT][NEUTRAL] For year [PII], yeah, they've only satisfied 250.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Only 250, including this scheme, right?
[AGENT][NEUTRAL] 250, 250.
[CUSTOMER][NEUTRAL] It's 2:15, including this claim, right?
[AGENT][NEUTRAL] It's not 215, it's 250, 250.
[CUSTOMER][NEUTRAL] Be.
[AGENT][NEUTRAL] Yes, that's what they've meant so far, including this claim.
[CUSTOMER][NEUTRAL] I, I just stated the same.
[CUSTOMER][NEUTRAL] That's what I was just asking you. OK, no problem. So, could you please help me to fax the PDOB?
[AGENT][NEUTRAL] Yeah, so the claim was processed today. The EOB is gonna mail out to the address on the claim on tomorrow. Otherwise you can download it from our website at [PII].
[CUSTOMER][NEUTRAL] OK. Not a problem. So could you please, uh, um,
[CUSTOMER][NEUTRAL] Send me the fax tomorrow at least.
[AGENT][NEUTRAL] Well, it's gonna, it's gonna mail out tomorrow morning to the address that's on the claim.
[AGENT][NEUTRAL] It was just processed on today.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, no problem. What would, what could be the reason for this call?
[AGENT][NEUTRAL] It's my name and today's date, [PII], first initial last name is [PII] and [PII], did you have any other questions?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] No. Thank you for the information, [PII]. Have a nice day. Bye-bye for now. It's a pleasure to speak to you.
[AGENT][POSITIVE] You're welcome, thanks for calling APL have a good day.
[CUSTOMER][NEUTRAL] Oh