AccountId: 011433970860
ContactId: 0b8e9a05-ebfc-4f6a-8a54-82c92b4674d0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 413209 ms
Total Talk Time (AGENT): 107363 ms
Total Talk Time (CUSTOMER): 219916 ms
Interruptions: 9
Overall Sentiment: AGENT=1.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/0b8e9a05-ebfc-4f6a-8a54-82c92b4674d0_20250425T15:09_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, is this for claims department?
[AGENT][POSITIVE] It is. How can I help you today?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK, uh, this is [PII] calling from the business office of West Boca Medical Center, and I'm checking for a bill status for claims.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, you have one claim to check for an appeal status on?
[CUSTOMER][NEUTRAL] Yes, for a pill study.
[AGENT][NEUTRAL] OK, so you're checking claim status? Did I misunderstand? You're just needing claim status?
[CUSTOMER][NEUTRAL] Uh yeah that and claim for appeal.
[AGENT][NEUTRAL] Yes, I can help you with that, [PII], and what is your callback number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][POSITIVE] Thank you and the member's policy number please.
[CUSTOMER][NEUTRAL] It is 018.
[CUSTOMER][NEUTRAL] 412.
[CUSTOMER][NEUTRAL] 11 and Mary Lima 7.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information that I do provide for you today would be a verification of benefits salary and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, the patient's name is [PII] with the birth of [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] What is the date of service and total bill amount for her please [PII]?
[CUSTOMER][NEUTRAL] Day of service is [PII].
[CUSTOMER][NEUTRAL] And the total charge is $16,065 even.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, actually, um.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Well I mean that uh that um we have like uh uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, just a moment, please, and let me look at a few things.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Uh, I have, uh, uh, phone number and also the um um like a lot.
[CUSTOMER][NEUTRAL] I uh do you know.
[AGENT][NEUTRAL] I'm trying to pull some additional information, so bear with me just one moment, please.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK sure.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah, sure and then um.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But I've been posting.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, so yes, ma'am, I do see that this was received. It has been processed and
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That was most recently received.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] Oh well.
[AGENT][NEUTRAL] And processed on [PII].
[CUSTOMER][NEUTRAL] Um, is there.
[CUSTOMER][NEUTRAL] Sorry, is there any recent one on [PII]?
[AGENT][NEUTRAL] Uh, no, ma'am, not as of this time.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So we need to allow more time.
[AGENT][NEUTRAL] You said
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] The most recently received appeal that has been processed was back in [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the appeal was upheld.
[CUSTOMER][NEUTRAL] OK, because I'm checking for the recent one on [PII].
[AGENT][NEUTRAL] OK. We have not processed another appeal. Yes, ma'am. And as of now, that has not been received or processed.
[CUSTOMER][NEUTRAL] Uh first name.
[CUSTOMER][NEUTRAL] OK, OK, thank you, that would be all. May I have the call reference?
[AGENT][NEUTRAL] Uh, your family, which is my name along with today's date.
[CUSTOMER][NEUTRAL] It's.
[AGENT][NEUTRAL] And you should also be able to access the status as well in our portal by going to [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Oh, maybe this.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Absolutely
[AGENT][NEUTRAL] And could I help you with anything else?
[CUSTOMER][POSITIVE] OK thank you have a great day.
[AGENT][POSITIVE] Oh, you're welcome. So if that's it all.
[CUSTOMER][NEUTRAL] That's all.
[AGENT][POSITIVE] Well then, thank you for calling APL and I hope you have a very nice weekend.
[CUSTOMER][NEUTRAL] You too, bye.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.