AccountId: 011433970860
ContactId: 0eff5ccf-ccb9-4ddd-a80e-f6092cfa805e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 471049 ms
Total Talk Time (AGENT): 139308 ms
Total Talk Time (CUSTOMER): 115368 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/0eff5ccf-ccb9-4ddd-a80e-f6092cfa805e_20250403T16:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi. My name is [PII], calling from AdventHealth, checking on a claim. Can you please help me with that?
[AGENT][NEUTRAL] OK, I can help you with claim status and what was your name again, sir?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII], OK, [PII], what's your callback number, sir?
[CUSTOMER][NEUTRAL] Yes, sure. My callback number is [PII].
[AGENT][NEUTRAL] Thank you, sir. And then can I please have the insured's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, just give me a second.
[CUSTOMER][NEUTRAL] The patient's name is [PII].
[CUSTOMER][NEUTRAL] And the policy number is 02424882 M as in Mike, L as in Lima, 8.
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][POSITIVE] Thank you. Let me pull up that policy real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and then what's the date of service and the charge amount?
[CUSTOMER][NEUTRAL] the data services.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the total charge amount is $3,578 even.
[AGENT][NEUTRAL] OK, and then what's the charge after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh, primary paid 1,25 sorry.
[CUSTOMER][NEGATIVE] My bad, primary paid $1,07.55.
[CUSTOMER][NEUTRAL] And remaining
[CUSTOMER][NEUTRAL] Coinsurance of $251.91 have been billed to secondary commission.
[AGENT][NEUTRAL] OK, thank you. And can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So it's Advent Health Orlando.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, [PII], while I pull up this claim for us and I will be right back, sir.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, [PII], thank you very much for holding for me. I have the claim pulled up for you.
[AGENT][NEUTRAL] The claim number is 3,582,870.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was paid $227.31.
[AGENT][NEUTRAL] With check number 203-6270. After that payment, it exhausted the benefits.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][POSITIVE] And I do show that the check is still outstanding as it was just sent on um let me tell you the date.
[AGENT][NEUTRAL] It was just mailed out on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I have the claim number again?
[AGENT][NEUTRAL] Yes, it's 358-2870.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. May I know the received date?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] That.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Can I have the receipt and processed it?
[AGENT][POSITIVE] Oh yes, sir. Let me look that up for you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We received it on [PII] and processed it on [PII].
[CUSTOMER][NEUTRAL] OK. So the loan amount is $227.31 and there's a denial on this, right?
[AGENT][NEGATIVE] No, it's not denied it was paid and then once that check was cut, it exhausted the benefits.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] 67. Uh, can you please explain to me?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] The insured only had that amount of money left.
[AGENT][NEUTRAL] For the benefit for the calendar year, so once that check was paid, it exhausted the benefits for the calendar year.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] So that month's payment will be.
[CUSTOMER][NEUTRAL] Paid, right?
[AGENT][NEUTRAL] All we're paying is 22731.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK. Can you please spell your name with the last name initial?
[AGENT][NEUTRAL] Yes, it's [PII] and the last initial is A.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Is it a check or single check?
[AGENT][NEUTRAL] It's single.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] OK. Can I get the call reference for this?
[AGENT][NEUTRAL] You can use my name and today's date.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. Thank you for the assistance. Have a great day.
[AGENT][POSITIVE] You too [PII] thank you for calling APL. There's nothing else I can help you with before we go?
[CUSTOMER][POSITIVE] Nothing else today. Thank you.
[AGENT][POSITIVE] OK, well, you take care and thanks for calling APL sir. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.