AccountId: 011433970860
ContactId: 09bd2509-6587-4928-8ba0-2dbb2baa248e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 339660 ms
Total Talk Time (AGENT): 74255 ms
Total Talk Time (CUSTOMER): 92579 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/09bd2509-6587-4928-8ba0-2dbb2baa248e_20250618T15:35_UTC.wav
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[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], my name is [PII]. I'm calling from AdventHealth Imaging today calling in reference to a claim status.
[AGENT][NEUTRAL] I can help you with claim status. [PII]. Can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, of course, [PII]. That is a direct line.
[AGENT][NEUTRAL] And do you have the policy number with you?
[CUSTOMER][NEUTRAL] 02451577.
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And do you have the claim number or the date of service?
[CUSTOMER][NEUTRAL] It is February 18, 2025 for $27.
[AGENT][NEUTRAL] OK, let me check.
[AGENT][NEUTRAL] And uh was the provider AdventHealth?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEGATIVE] Not showing one for AdventHealth.
[AGENT][NEUTRAL] Would it be under any
[CUSTOMER][NEUTRAL] Could be under Florida Hospital Medical.
[AGENT][NEUTRAL] Medical group? OK.
[CUSTOMER][NEUTRAL] Florida Hospital Medical Group.
[AGENT][NEUTRAL] OK, I just wanted to make sure.
[AGENT][NEGATIVE] It looks like that was denied because the inpatient benefit for that calendar for this calendar year had been met.
[AGENT][NEUTRAL] Do you need the claim number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hold on just, OK, yeah, let's do the claim number real quick. Go ahead.
[AGENT][NEUTRAL] It's 360-4221.
[CUSTOMER][NEUTRAL] OK, you said denied due to
[CUSTOMER][NEUTRAL] Can I do to maximum.
[AGENT][NEUTRAL] They met their right they met their calendar your maximum for inpatient services.
[CUSTOMER][NEUTRAL] OK, hold on, due to calendar.
[CUSTOMER][NEUTRAL] Maximum.
[CUSTOMER][NEUTRAL] Calendar.
[CUSTOMER][NEUTRAL] Here
[CUSTOMER][NEUTRAL] Met
[CUSTOMER][NEUTRAL] Correct. Is that right?
[AGENT][POSITIVE] Yes ma'am, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And when was that denied?
[AGENT][NEUTRAL] Check
[AGENT][NEUTRAL] Uh, it looks like we processed this claim on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 791.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, and I do have the, the, um, EOB. Perfect. So I can go ahead and
[CUSTOMER][NEUTRAL] Um, is there a minimum, is there a discount or what he can be or can he be charged for it all?
[AGENT][NEUTRAL] Uh, we don't handle patient responsibility.
[CUSTOMER][POSITIVE] OK, great.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright, perfect, and can I get a reference number please?
[AGENT][NEUTRAL] So we don't have call reference numbers, but you can use my name and last initial in today's date, so [PII]
[CUSTOMER][NEUTRAL] What is your
[AGENT][NEUTRAL] [PII],
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] All right, thank you so much. I do hope you enjoy the rest of your day.
[AGENT][POSITIVE] Thank you for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.