AccountId: 011433970860
ContactId: 15a704f0-79a4-4ad8-a9ea-dd65036d6c96
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 429619 ms
Total Talk Time (AGENT): 152482 ms
Total Talk Time (CUSTOMER): 105139 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/15a704f0-79a4-4ad8-a9ea-dd65036d6c96_20250312T18:08_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII] how are you?
[AGENT][POSITIVE] I'm doing well. How are you?
[CUSTOMER][POSITIVE] I'm doing well thank you for asking. My name is [PII] and I'm calling from Boca Raton Regional Hospital to get information regarding claims.
[AGENT][POSITIVE] OK, well I can definitely help you with the claim status and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 02209981.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you'd like me to check on?
[CUSTOMER][NEUTRAL] The first one is [PII].
[AGENT][NEUTRAL] And the total bills?
[CUSTOMER][NEUTRAL] $45,847.80.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] And it was 1710 of 23. Let me look at this one.
[AGENT][NEUTRAL] Do you mind if I place you on just a brief hold?
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Alright, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] I think it's a facility charge, but let's see.
[AGENT][NEUTRAL] 3354902902902.
[AGENT][NEUTRAL] 333.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Uh see how is it.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. Um, is there any other total bill that it could be?
[CUSTOMER][NEUTRAL] Um, let's see here because for some reason UnitedHealthcare splits the bill out, so.
[CUSTOMER][NEUTRAL] Did I get what I did I give you $45,847.80?
[AGENT][POSITIVE] Yes, now I do, yes.
[CUSTOMER][NEUTRAL] That's what I gave you?
[CUSTOMER][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And what's your, um, let me see if this is the um
[AGENT][NEUTRAL] Same tax ID because the closest one, hold on 108.
[AGENT][NEUTRAL] What's your tax ID? Hold on.
[CUSTOMER][NEUTRAL] 591
[AGENT][NEUTRAL] Hold on, this is a different amount. Hold on one second, 49.
[AGENT][NEUTRAL] Because there's several from that day. OK, here it is. OK, what's your um tax ID?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, so this is the same tax ID, but the total bill that came over was $60,659.36. That's the closest one to your total.
[CUSTOMER][NEUTRAL] Uh, let's see, let's see, let's, and it's for [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The other amounts were like 300, like smaller.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][POSITIVE] Right, you're correct. I'm wrong.
[CUSTOMER][NEUTRAL] Um, because there is, yeah, it's $60,659.36.
[AGENT][NEUTRAL] This is it.
[AGENT][NEUTRAL] OK, here we go. Hold on one second, let me get the dates for you.
[CUSTOMER][NEUTRAL] And the thing is United um unit, we send it out as one claim but united somehow splits them all up into little, I don't know why I don't know, it's confusing, but you're correct.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Very.
[AGENT][NEUTRAL] OK, hold on, let me just get the dates for you. OK, so we received the claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that claim number is 33549002.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[AGENT][NEUTRAL] Because the services were rendered after coverage was terminated.
[AGENT][NEUTRAL] So this policy was active from [PII].
[CUSTOMER][NEUTRAL] July, give me, give me the dates one more time.
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] To [PII].
[CUSTOMER][NEUTRAL] OK, so that means the other 3 days of service is gonna, um.
[CUSTOMER][NEUTRAL] Follow up on this as well.
[CUSTOMER][NEUTRAL] Because it's after July.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Oh, after the [PII].
[CUSTOMER][POSITIVE] Correct, mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So can I have a reference number for the call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. Um that's [PII], [PII] initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK, perfect. You say [PII] or just [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK perfect thank you you have a great day.
[AGENT][NEUTRAL] You also, [PII], was there anything else I can help with?
[CUSTOMER][NEUTRAL] No, that'll be all.
[AGENT][POSITIVE] Alright, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm.