AccountId: 011433970860
ContactId: 2e66a5da-e175-4822-905f-1a67a40df674
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 314290 ms
Total Talk Time (AGENT): 123606 ms
Total Talk Time (CUSTOMER): 79726 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/2e66a5da-e175-4822-905f-1a67a40df674_20250321T12:57_UTC.wav
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[AGENT][POSITIVE] Good Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I'm calling from Florida Hospital for claim status.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you, and I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] No, yeah.
[AGENT][NEUTRAL] [PII], thank you. And a callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Um, D as in dog, 46401588.
[AGENT][NEUTRAL] That is not the APL policy. Our policies are all numerical, starting with a 0.
[AGENT][NEUTRAL] Do you happen to have another number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let me, let me see if I have uh a copy of the insurance card.
[CUSTOMER][NEUTRAL] Go
[CUSTOMER][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] I don't have the, the copy of the insurance card.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's not a problem. What is the patient's last name?
[CUSTOMER][NEUTRAL] Let's see, I see that a little.
[CUSTOMER][POSITIVE] Um, [PII].
[AGENT][NEUTRAL] Is it [PII]?
[CUSTOMER][NEUTRAL] It's um [PII] Yes.
[AGENT][POSITIVE] [PII], got it. And then [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's for medical claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you, [PII]. And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] That's on [PII].
[AGENT][NEUTRAL] All right, thank you. I can provide her medical ID number if you would like.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] 4120
[CUSTOMER][NEUTRAL] ID number, OK.
[AGENT][POSITIVE] And it would be my pleasure to help you with that claim status today, [PII]. What is the data service?
[CUSTOMER][NEUTRAL] It's um [PII] built amount $777.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm checking, bear with me just one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the name of the facility?
[CUSTOMER][NEUTRAL] Facility name is Advent Health West Florida.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] [PII], we did receive that claim on [PII].
[AGENT][NEUTRAL] And processed on [PII].
[AGENT][NEUTRAL] And the claim was denied as a non-covered diagnostic test.
[AGENT][NEUTRAL] This policy only provides a diagnostic benefit for MRI, CAT scan, thyroid uptake, CT scan, PET scan, angiogram.
[AGENT][NEUTRAL] Upper GI series sleep study and transesophageal echocardiogram. So it's non-covered diagnostic testing.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] I don't
[AGENT][NEUTRAL] And I can provide that claim number.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Um, yes, please.
[AGENT][NEUTRAL] Claim number is 357.
[AGENT][NEUTRAL] 3961.
[AGENT][NEUTRAL] And y'all should be receiving that EOB shortly. It went out on [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Thank you so much for your time.
[AGENT][POSITIVE] It's been a pleasure to assist you with that claim status, [PII]. Anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much.
[CUSTOMER][NEUTRAL] Mm
[AGENT][POSITIVE] Thank you for calling APL. I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] You too. Thank you so much.
[AGENT][POSITIVE] Thank you, [PII]. Take care. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.
[CUSTOMER][POSITIVE] Take care. Bye-bye.