AccountId: 011433970860
ContactId: 4260176a-04ad-4465-a5ad-01837b781a02
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 314549 ms
Total Talk Time (AGENT): 146387 ms
Total Talk Time (CUSTOMER): 52384 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/4260176a-04ad-4465-a5ad-01837b781a02_20250116T18:23_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Yes ma'am. My name is [PII]. I'm trying to get status on a claim.
[AGENT][POSITIVE] Claim status, OK. I'd love to help you with some claim status today, ma'am. May I have your name, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, [PII]. And do you mind if I get a really good call back number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And do you have that policy number handy, Ms. [PII]?
[CUSTOMER][NEUTRAL] 0220.
[CUSTOMER][NEUTRAL] 3919 M as in Mary, L as in Larry number 7.
[AGENT][POSITIVE] Thank you. I appreciate that. Give me 1 2nd to get there for you.
[AGENT][NEUTRAL] All right. And then can you verify?
[AGENT][NEUTRAL] Um, the first and last name for the person we're needing that claim on today?
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII].
[AGENT][NEUTRAL] [PII]. OK, perfect, and I'm seeing that right here. One second.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] [PII], I'm so sorry, but for my notes, um, what group are you calling from today?
[CUSTOMER][NEUTRAL] Miami-Dade County Fire Rescue.
[AGENT][POSITIVE] Thank you, I appreciate that.
[AGENT][NEUTRAL] And do you know the date of service for that claim you want to check or the claim number in particular?
[CUSTOMER][NEUTRAL] [PII] or 24.
[AGENT][POSITIVE] Perfect and that total bill amount today?
[CUSTOMER][NEUTRAL] 9:40 even.
[AGENT][POSITIVE] 9:40, perfect. That's gonna be this one right here.
[AGENT][NEUTRAL] All right, and I do see that we received your claim on
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] [PII], we processed the claim on.
[AGENT][NEUTRAL] I'm so sorry. I like, just stop thinking on 1024-2024, and I have your claim number listed as 3521734, and I'm actually showing it denied as a duplicate, so let me look into it further and see if I had another claim on file um for that same date of service.
[AGENT][NEUTRAL] OK, 881.
[AGENT][NEUTRAL] Alright, so I do, I actually have a claim on file as well. It looks like it was submitted [PII] and processed [PII]. That original claim number is 3503881.
[AGENT][NEGATIVE] And I do show it was denied requesting a copy of the explanation of benefits from the primary insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] From [PII]. Oh yeah, yeah, [PII].
[AGENT][NEUTRAL] No, we're the secondary insurance, so we're like a gap coverage.
[CUSTOMER][NEUTRAL] I try.
[CUSTOMER][NEUTRAL] One gap.
[CUSTOMER][NEUTRAL] And do you know the primary cause all I see is.
[AGENT][NEUTRAL] Yeah, I can take a look and see what we have listed as that primary insurance for you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Alright, I'm showing that their major medical provider is Cigna.
[CUSTOMER][POSITIVE] OK, thank you, thank you so much. So you said the claim number is 3503881.
[AGENT][NEUTRAL] 3503881, yes.
[CUSTOMER][NEUTRAL] OK, thank you and do you have a problem?
[CUSTOMER][NEUTRAL] Maybe
[AGENT][NEUTRAL] Yeah, we have a car. Um well, it's not a number, but it's just my name [PII], first initial last name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much ma'am.
[AGENT][POSITIVE] Yeah my pleasure, and then we don't have any time limits so once you get that process through Cigna, um, just send us that EOB and we'll reconsider, OK?
[CUSTOMER][POSITIVE] OK thank you ma'am.
[AGENT][POSITIVE] My pleasure. You have a great day, [PII]. Thank you for calling APL.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] Bye bye.