AccountId: 011433970860
ContactId: 387036bf-9528-4eae-b64f-f97928cd0830
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177380 ms
Total Talk Time (AGENT): 50097 ms
Total Talk Time (CUSTOMER): 76556 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/387036bf-9528-4eae-b64f-f97928cd0830_20250416T18:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh yes, hi, I need to claim status please.
[AGENT][NEUTRAL] OK, I can help you with claim status. Can I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and the number is [PII].
[AGENT][NEUTRAL] And are we your provider's office, [PII]?
[CUSTOMER][NEUTRAL] Yeah, it's from our facility, University of Miami Hospital and Clinics.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is that policy number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] 02027787 ML 8.
[AGENT][NEUTRAL] OK, thank you. And you have the patient name and date of birth?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes, [PII]. Date of birth [PII].
[AGENT][NEUTRAL] What was that date of service?
[CUSTOMER][NEUTRAL] [PII], the amount was $32,0042.00.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You know, I'm going for the EOBs. I think you've paid $1000 here. See what you'll find there.
[AGENT][NEUTRAL] Yes, looks like we pay 1000.
[CUSTOMER][NEUTRAL] But it was more.
[CUSTOMER][NEUTRAL] Right, and we, um, yeah, the EOB from Signal was 161528 cents. So is there a denial that you didn't pay the whole amount?
[AGENT][NEUTRAL] Um, let me see what the benefit is.
[AGENT][NEUTRAL] Probably 1000, let me see.
[AGENT][NEUTRAL] Yeah, the full, uh, the max benefit is 1000, so it just, it just paid out the maximum.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Does this go to the patient, uh, the balance of the 600 in your EOB?
[AGENT][NEUTRAL] No, we don't determine patient responsibility since this is a secondary policy. We just simply process according to what the policy states.
[CUSTOMER][NEUTRAL] OK, so it just smacks so.
[CUSTOMER][POSITIVE] Max of patients benefits.
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me just check that claim number. Is it 354527-9?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, [PII], thank you. Can I have the reference number for the call?
[AGENT][NEUTRAL] Uh, it's just my name, [PII], first initial to last name, [PII], and today's date. Can I help with anything else today?
[CUSTOMER][POSITIVE] That'll be all, thank you. Appreciate it.
[AGENT][POSITIVE] OK, thanks, thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You too. Bye-bye.