AccountId: 011433970860
ContactId: 38a8a229-7be2-47bb-b4d0-98fe08917d14
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211479 ms
Total Talk Time (AGENT): 88545 ms
Total Talk Time (CUSTOMER): 78806 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/38a8a229-7be2-47bb-b4d0-98fe08917d14_20250326T17:40_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm with the provider's office and I'm just trying to get a claim status for a patient.
[AGENT][NEUTRAL] Sure, I can check on a claim for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I do. I have it as 02549402, M as in Mike, L as in Lima, number 7.
[AGENT][NEUTRAL] OK, and that was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] It is gonna be for [PII], and the date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that and what was the date of service claim?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The date of service is going to be for [PII].
[AGENT][NEUTRAL] OK, do you have that bill amount?
[CUSTOMER][NEUTRAL] I do. It's $384.
[AGENT][POSITIVE] I'm so sorry that kind of cut out there. How much?
[CUSTOMER][NEUTRAL] $384.
[AGENT][NEUTRAL] 84. OK, thank you. One moment please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] I'm sorry, this was for uh Advent, excuse me, AdventHealth.
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so we did receive this claim. Uh, we were unable to pay a benefit as the services are not covered when performed in a doctor's office or clinic.
[AGENT][NEUTRAL] For this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Was there a specific, because it was just an office exam. Oh, it's a preventative, so she doesn't have prevent visit um benefits.
[AGENT][NEUTRAL] Uh, yeah, this, since it's a secondary medical policy, they are all a bit different, um, and some have treatment, uh, covered in office and others don't, so this one does not. Um, and if you'd like, I can send you a copy of this EOB.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Yeah, that would be great actually. I do appreciate that.
[AGENT][NEUTRAL] Sure, do you have a fax number?
[CUSTOMER][NEUTRAL] I do. Um, the fax number is [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII]?
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][POSITIVE] That's correct, yes.
[AGENT][POSITIVE] All right, got it. I will go ahead and get that sent to you now. um, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] No, that's all I needed. Uh, do you have a reference number though for the call?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII], last initial is A.
[CUSTOMER][POSITIVE] Perfect. Well, thank you so much. I appreciate your help.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thanks bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.