AccountId: 011433970860
ContactId: fe1c7249-a011-40e3-b516-ce9c782cd51b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243630 ms
Total Talk Time (AGENT): 93829 ms
Total Talk Time (CUSTOMER): 82155 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/fe1c7249-a011-40e3-b516-ce9c782cd51b_20250502T14:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII]. I need to know about the claim status.
[AGENT][NEUTRAL] OK, I could check on a claim for you. I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] [PII], last [PII] [PII].
[AGENT][NEUTRAL] Got it. [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the extension is [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, policy number is 02478971.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] First name, [PII] Last name [PII] Date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] OK, do you have that bill amount?
[CUSTOMER][NEUTRAL] Yes, $1,273 even.
[AGENT][POSITIVE] Got it. Thank you. One moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII], we were unable to pay a benefit as the maximum benefit payable for this date of service had been met.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know about the total benefits amount?
[AGENT][NEUTRAL] Yes, so, uh, on this policy, uh, excuse me one moment.
[AGENT][NEUTRAL] So this policy's outpatient benefit paid on a per calendar day basis. It paid a maximum of $500 per calendar day.
[CUSTOMER][NEUTRAL] For calendar day.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How much the patient made?
[AGENT][NEUTRAL] They had already so that $500 benefit was already paid for a claim that was already that was also on that date of service.
[AGENT][NEUTRAL] So we paid the benefit maximum for the service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. You have any other active insurance for the date of service?
[AGENT][NEGATIVE] Not with us. If they did, it would not be with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I have your name, please?
[AGENT][NEUTRAL] Sure, it's [PII]
[AGENT][NEUTRAL] Was there anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I have the call reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. uh, so my last initial is [PII], uh, did you need this claim number or anything?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes. May I have the claim number?
[AGENT][NEUTRAL] Yes, that's 358-768-2.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] Of course is there anything else I can help you with?
[CUSTOMER][POSITIVE] Thank you for your assistance. OK.
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] All right, well thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Have a great day. Happy weekend.
[AGENT][POSITIVE] You too thank you bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.