AccountId: 011433970860
ContactId: 40ccbb86-c29e-423c-95f5-9f4a6d40722e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 253020 ms
Total Talk Time (AGENT): 92973 ms
Total Talk Time (CUSTOMER): 129003 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/40ccbb86-c29e-423c-95f5-9f4a6d40722e_20250130T21:10_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APO. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I need to check on some claims please.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] [PII]. Her policy number is 02337170 M as in Mary, L as in Larry 7.
[AGENT][NEUTRAL] What is this member's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] And what is the date of service that you're inquiring claim status for and I'll be able to assist you?
[CUSTOMER][NEUTRAL] Yeah, the first one is [PII]. This is her secondary insurance. Her primary, um, is AdMed. They applied, um, this claim to her deductible. We send it in to you guys in October. Do you have it?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we made a payment of $1000.
[CUSTOMER][NEUTRAL] Oh, when did you make the payment of $1000? I don't have it.
[AGENT][NEUTRAL] 39.
[AGENT][NEUTRAL] And what was the date of service?
[CUSTOMER][NEUTRAL] It was [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] So we sent the check out [PII]. It was it was cashed [PII].
[CUSTOMER][NEUTRAL] Do you have an EFT number or check number?
[AGENT][NEUTRAL] Check number is 2010191. That's 2010191. That's for the Baptist surgery and endoscopic facility.
[CUSTOMER][NEUTRAL] Right, that's not us.
[AGENT][NEUTRAL] So what is your bill amount?
[CUSTOMER][NEUTRAL] Uh, we, we.
[CUSTOMER][NEUTRAL] Um, our bill amount originally was $4100 and what was left on the claim was 1,02996.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] This was for [PII].
[AGENT][NEUTRAL] I'm not showing the claim. I only have something from Baptist and South Miami Hospital.
[CUSTOMER][NEUTRAL] OK, we send it in electronically when it's secondary for you guys, do you want the EOB from the first insurance or no?
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] Yes, we, we have to have the ELB from the primary insurance because the secondary only pays if something went towards the deductible, co-pay, and the co-insurance.
[CUSTOMER][NEUTRAL] Correct. OK, so I'll get that for you and what is the address where I can mail this to, please?
[AGENT][NEUTRAL] The address will be.
[AGENT][NEUTRAL] [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]. And what was your name again? I apologize.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] [PII]. What was the ZIP code?
[AGENT][NEUTRAL] [PII]. That's [PII].
[CUSTOMER][NEUTRAL] [PII]. My name is [PII], like [PII]
[AGENT][NEUTRAL] And what was the amount on your claim?
[CUSTOMER][NEUTRAL] And can I have a
[CUSTOMER][NEUTRAL] Excuse me?
[AGENT][NEUTRAL] What was the amount of the claim?
[CUSTOMER][NEUTRAL] $4100 it was originally $4100 and then they uh Amet applied a contractual reduction and then what was left was $1,02996 that went to her deductible.
[AGENT][NEUTRAL] Thank you, and we don't provide reference numbers, but you can use my name in today's date as a reference.
[CUSTOMER][NEUTRAL] But uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, thank you.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, thank you. You have a great afternoon.
[AGENT][POSITIVE] Thanks for calling APL and have a great day.
[CUSTOMER][POSITIVE] OK thank you bye bye.
[AGENT][NEUTRAL] Data service.