AccountId: 011433970860
ContactId: 0e768b1e-a6cc-4645-bba0-200867e1e898
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 296559 ms
Total Talk Time (AGENT): 107715 ms
Total Talk Time (CUSTOMER): 63742 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/0e768b1e-a6cc-4645-bba0-200867e1e898_20250418T15:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], I uploaded um some bills that I had outstanding bills to the portal, um, about two weeks ago. I was calling to see if it was processed, uh, yet.
[AGENT][NEUTRAL] OK, I can help you look at your claim status. Do you have a, a policy number with that you can give me?
[CUSTOMER][NEUTRAL] Yeah. Yeah, the member ID is 679-624-085.
[AGENT][NEUTRAL] Um, see, that number is a little long. Um, what about your last name or social?
[CUSTOMER][NEUTRAL] OK, Social is [PII].
[AGENT][NEUTRAL] And what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me get that pulled up.
[AGENT][NEUTRAL] Do you have a good call back number [PII] just in case we're disconnected.
[CUSTOMER][NEUTRAL] Mhm. It's [PII].
[AGENT][POSITIVE] OK, thank you so much. And just need a few pieces of information. What is your birth date?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, thank you. And your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then lastly your email address.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, it looks like looking at the notes here.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, it looks like you provided or sent in a wellness expense, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, the wellness expense isn't covered under the policy, but I, I've got other things under here too. Let me see what we've got.
[AGENT][NEUTRAL] This is a hospital indemnity plan, so.
[AGENT][NEUTRAL] It provides cus uh coverage, um, not a guarantee, just a basic outline. It provides coverage for like hospital admission, confinement.
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Um, OK.
[AGENT][NEUTRAL] Then we received some charges for labs.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] What else
[AGENT][NEGATIVE] Looks like the labs were not covered, and then there was a $500 charge that we needed an itemization for.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Have you submitted something, uh, because we just processed all of these on [PII].
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] So does that mean it's gonna be paid to the um to advance uh help.
[CUSTOMER][NEUTRAL] Advent.
[AGENT][NEUTRAL] No, the, the wellness benefit is not covered under the policy, and neither are lab labs.
[CUSTOMER][NEUTRAL] You know
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then there was one charge for 500 that we're asking for um documentation of an itemized bill that shows like diagnosis codes, um uh hospital admission and discharge summaries.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, so that's what we've asked for additional information in order to be able to consider the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, um, I guess I could call, um, AdventHealth and upload that once I have it.
[AGENT][POSITIVE] Yes, correct. Yes.
[CUSTOMER][POSITIVE] Right, OK. All right, thank you.
[AGENT][NEUTRAL] Hm.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.