AccountId: 011433970860
ContactId: 306c49b3-a070-46eb-aed0-852ad1619415
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160919 ms
Total Talk Time (AGENT): 82092 ms
Total Talk Time (CUSTOMER): 64052 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/306c49b3-a070-46eb-aed0-852ad1619415_20250317T20:51_UTC.wav
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[AGENT][NEUTRAL] Contacting APO. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm with Baptist Health Medical Group, and I was calling for claim status. Can you help?
[AGENT][NEUTRAL] Yes, [PII], I can certainly help with the claim status. What is that policy number, please?
[CUSTOMER][NEUTRAL] That is 1480429 ML 7.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you. And is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][POSITIVE] I appreciate that. What date of uh service are we looking for for [PII]?
[CUSTOMER][NEUTRAL] We're looking at [PII] for $418.
[AGENT][POSITIVE] Appreciate that. Thank you. The claim number on this is 356.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 0922.
[AGENT][NEUTRAL] Now, the uh insured has uh so many uh so many uh benefits uh as far as inpatient services go, um, so for the calendar year, uh, we will pay up to $4000 for inpatient services. That's just a verification, not a guarantee of payment for hospital services. By the time that we received the claim, all of those benefits had already been used.
[AGENT][NEUTRAL] And so, um, the claim was denied because his uh his benefits for that calendar year had been uh exhausted.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, OK, so, um, before I called I tried looking up the claim on the.
[CUSTOMER][NEUTRAL] Secured [PII] website. I couldn't get the claim to pull up, um.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Is there, is there a way that I could maybe get a copy of that EOB um we haven't received or when did that actually deny? I'm sorry, I should have asked that first.
[AGENT][NEUTRAL] Yes, of course. Um, so it looks like this was denied, uh, on the [PII]. That should have come up, but if it didn't, um, I will be glad to fax that to you. What is your fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII]. OK. Let me go ahead and send that copy to you. Is there anything else that I, that I can help with?
[CUSTOMER][NEUTRAL] Nope, that was all.
[AGENT][POSITIVE] OK, I'll have this sent out to you and if you do have any questions, just let us know otherwise um thank you for contacting API. I hope you have a very good day. Thank you for calling us.