AccountId: 011433970860
ContactId: 35332d2c-f054-4680-a329-798b9f615808
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 425119 ms
Total Talk Time (AGENT): 121781 ms
Total Talk Time (CUSTOMER): 150709 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/35332d2c-f054-4680-a329-798b9f615808_20250129T21:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, hi, I'm calling from AdventHealth, and my name is [PII]. I'm calling for claim status, please.
[AGENT][NEUTRAL] May I have a callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] 0237 0768.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][NEUTRAL] And may I have the date of service and total bill charge?
[CUSTOMER][NEUTRAL] Uh, that's [PII].
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] Uh, total charges of $794.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] I'm pulling that information up for you now.
[CUSTOMER][POSITIVE] Sure thank.
[AGENT][NEUTRAL] And I did pull that claim up for you.
[AGENT][NEUTRAL] And it does show that that claim was processed and it was received, we get that receipt date for you.
[AGENT][NEUTRAL] It was received on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] That claim number is 353.
[AGENT][NEUTRAL] 5614 it processed and it made a payment in the amount of $75. Once that $75 was paid, that was the maximum amount that would be paid out on this claim. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEGATIVE] Yeah, we didn't receive the payment.
[CUSTOMER][NEUTRAL] How did you make the payment?
[AGENT][NEUTRAL] Via check.
[CUSTOMER][NEUTRAL] OK I have it I have the details because it is not received and where did you send it to?
[AGENT][NEUTRAL] You will have to verify that mailing address we send it to the one on the claim. Would you like to verify that with me please?
[CUSTOMER][NEUTRAL] Sure. It's uh [PII].
[AGENT][NEUTRAL] That's not the mailing address that is listed in [PII]. It shows [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh, OK. Uh, you know, I have seen this, uh, uh, issues about the address. Could you hold on one second, please? Let me look at it in the, in the clearing house quick, OK? If you don't mind.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because I wanna know how you receive that if it's uh.
[CUSTOMER][NEUTRAL] Alright, uh, this is for 12 13-2023. Thank you for holding.
[CUSTOMER][NEUTRAL] So the difference will be patient responsibility?
[AGENT][NEUTRAL] If there's an amount that was left over that is considered as patients responsibility.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And this is.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, I don't see 12:23 0 sorry.
[CUSTOMER][NEUTRAL] I entered 23 instead of 13.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] You said that uh did you see anything in box 32 and 33 or just box 33?
[AGENT][NEUTRAL] It's something in 31, 32, and 33.
[CUSTOMER][NEUTRAL] Alright, according to the claim that they dropped in the cleaning house.
[CUSTOMER][NEUTRAL] Uh, no, it has the pay to address.
[CUSTOMER][NEUTRAL] And your address that you see, let me write it down again, please. What is it?
[AGENT][NEUTRAL] The address that was submitted in on the claim, which is the image that I'm looking at, is [PII].
[AGENT][NEUTRAL] So if that is the incorrect mailing address, you would have to submit the corrected claim with the corrected mailing address.
[CUSTOMER][NEUTRAL] How are you?
[CUSTOMER][NEUTRAL] All right, is there any time time for this?
[AGENT][NEGATIVE] There is no timely filing.
[CUSTOMER][NEUTRAL] And uh and uh do you have any facts or anything like that?
[AGENT][NEUTRAL] Yes, you can submit it via fax. Let me get that for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] That fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and that is attention claims department.
[CUSTOMER][NEUTRAL] Yeah, but you, uh, you want me to send it as a correct the claim? It won't drop as a correct the claim if I send you the one in the cleaning house, and this is for, uh, you said the same amount, and then the doctor [PII], right? Do you see that?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Mm, I don't know how you got it with a different address. Hmm.
[CUSTOMER][NEUTRAL] All right, uh, OK, I'll send you the collectively. I'm gonna fax it all. What is your name again?
[AGENT][NEUTRAL] It is [PII]. Would you like me to spell that for you?
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] OK, that is spelled [PII] Last [PII] of [PII] and today's date will be the call reference.
[CUSTOMER][POSITIVE] All right. OK. Thank you very much for your help. You have a good day.
[AGENT][POSITIVE] You're welcome thank you for calling American Public Life. Have a great day as well.
[CUSTOMER][POSITIVE] Bye-bye, thanks.
[AGENT][NEUTRAL] Bye