AccountId: 011433970860
ContactId: 345ce8d4-16cd-4182-b4ab-350e2a142ccd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 886950 ms
Total Talk Time (AGENT): 187646 ms
Total Talk Time (CUSTOMER): 274727 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/345ce8d4-16cd-4182-b4ab-350e2a142ccd_20250305T17:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, good afternoon. My name is [PII] My last initial is [PII]. Well, I'm calling from AdventHealth regarding the claim status.
[AGENT][POSITIVE] OK, [PII], I'm happy to check a claim status for you today. Do you by chance have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh yeah, sure. It is 022 03942 M as in Mary, L as in Lima, 8.
[AGENT][POSITIVE] Thank you for that [PII] and do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. It is [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][POSITIVE] Alright thank you so much let me just pull this up here.
[CUSTOMER][NEUTRAL] I just.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I I help.
[AGENT][NEUTRAL] What's the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] The first name is [PII], the last name is [PII]. The date of birth is on [PII].
[AGENT][POSITIVE] Thank you so much. And then what is the data service?
[CUSTOMER][NEUTRAL] It is for [PII].
[AGENT][NEUTRAL] And the build them out.
[CUSTOMER][NEUTRAL] It is for $331 even.
[AGENT][POSITIVE] All right thank you one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, give me just one moment to double check the charge.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] How.
[CUSTOMER][NEUTRAL] This one I think.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][NEUTRAL] Which one I
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] There.
[AGENT][NEUTRAL] OK, so it looks like we did receive a claim for the state of service. I'm showing that a benefit payment was made in the amount of 11763.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Like, uh, do you meant to say that the primary has processed or something like that?
[AGENT][NEUTRAL] We don't have any of the primary insurance information. We're the secondary. We received the claim for the state of service on [PII], and the claim is processed on [PII]. Uh, we sent the benefit payment in the amount of 11763, it looks like.
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] Oh, as in deductible, uh, car insurance, or co-payment?
[AGENT][NEUTRAL] Mhm. That was the allowed amount, it looks like.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] So, is the complete allowed amount paid by American Public Life?
[CUSTOMER][NEUTRAL] Or just apply it towards the patient's responsibility.
[AGENT][NEUTRAL] We're not able to advise on the patient responsibility that would be up to the facility or provider based off of this data service, this is the maximum benefit payable it looks like.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. Uh, so may I know, uh, if the UP was released?
[AGENT][NEUTRAL] Yeah, would you like a copy of the EOB?
[CUSTOMER][NEUTRAL] Yeah, sure, please.
[AGENT][NEUTRAL] Do you have a good fax number?
[CUSTOMER][NEUTRAL] Yes, ma'am. Just a moment.
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] So just to confirm [PII] [PII]?
[CUSTOMER][POSITIVE] Yes, perfect.
[AGENT][NEUTRAL] OK, so that should be there in about 5 minutes. Is there anything else I can check on for you?
[CUSTOMER][NEUTRAL] Uh, may I know, uh, which mode of payment it was paid?
[AGENT][NEUTRAL] Uh, it was a single check.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you need the check number?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, let me get that for you. One moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Check number is 202-6906.
[CUSTOMER][NEUTRAL] Mm OK. And it was paid on [PII], right?
[AGENT][POSITIVE] Mhm, that is correct.
[CUSTOMER][NEUTRAL] Is there any in cash date?
[AGENT][NEUTRAL] Uh, let me see if it's been cash. One moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Uh, it's still showing outstanding on our side.
[CUSTOMER][NEUTRAL] Oh, OK. Um.
[CUSTOMER][NEUTRAL] And may I know the address that was sent to?
[AGENT][NEUTRAL] Uh, it was sent to [PII].
[CUSTOMER][NEUTRAL] Uh, usually the payments, uh, were to be sent, uh, to, one moment, I'll just provide you that.
[AGENT][NEUTRAL] Was it for Advent Health Laboratories?
[CUSTOMER][NEUTRAL] Yes, uh, one moment, let me just find out, yeah, uh, the payments should be paid usually to [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'll need to check the claim on this, [PII], because if that was the address submitted, then we need a corrected claim.
[CUSTOMER][NEUTRAL] Well, actually, this is the facility's address, but however, the payments would have to be sent uh to this address which I have provided. Could you please give me a moment? I'll just verify with that.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Yeah, thank you so much. One moment.
[CUSTOMER][NEUTRAL] Uh hello.
[AGENT][NEUTRAL] Mhm, I'm still here.
[CUSTOMER][POSITIVE] Thank you so much for patiently waiting. Uh, well, actually I verified, uh, basically the payments uh should be sent to.
[CUSTOMER][NEUTRAL] Uh, physical address that is [PII].
[CUSTOMER][NEUTRAL] Could you please verify, verify that for me once again?
[AGENT][NEUTRAL] I'm looking to see what was submitted on the claim, uh, to see if we need a new claim submitted on the claim form. Give me one moment please.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK [PII], I'm gonna have to reach out to the claims adjuster to see um if we can get the address corrected to the [PII].
[CUSTOMER][NEUTRAL] I'm sorry. So do we have to contact them?
[AGENT][NEUTRAL] No, I just need to have it reprocessed and sent to the correct address so there's nothing that you need to do on your end.
[CUSTOMER][NEUTRAL] OK. Uh, so, uh, could you please, uh, issue to stop the check?
[AGENT][POSITIVE] Yes, ma'am, that's what I'm gonna do.
[CUSTOMER][POSITIVE] OK. Thank you so much for that.
[CUSTOMER][NEUTRAL] And uh can I have the turnaround time?
[AGENT][NEUTRAL] Uh, reprocessing will take at least 5 to 7 days for a new check to be sent out.
[CUSTOMER][POSITIVE] OK, 5 to 7 business days. OK, thank you so much for that. And um.
[CUSTOMER][POSITIVE] Yeah, perfect. Can I get the call reference number?
[AGENT][NEUTRAL] Call reference is my name with my last initial than today's date. My name again is [PII], which is [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] OK, [PII], so uh just to confirm once again that there is no denial on the claim, right?
[CUSTOMER][NEUTRAL] Mm
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII]. Have a great day ahead.
[AGENT][NEUTRAL] You too bye bye.