AccountId: 011433970860
ContactId: 4c63608d-fc2b-450a-960c-9342f474185e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 391179 ms
Total Talk Time (AGENT): 152889 ms
Total Talk Time (CUSTOMER): 110361 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/4c63608d-fc2b-450a-960c-9342f474185e_20250109T14:37_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII] speaking. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office. Could you please help me with the claim status?
[AGENT][NEUTRAL] Sure [PII], I can help you with the claim status. May I please have your call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, that's
[CUSTOMER][NEUTRAL] Mhm. That's [PII].
[AGENT][NEUTRAL] Thank you and [PII], may I have the name of the provider or facility you're calling from, please?
[CUSTOMER][NEUTRAL] Yes, that's Advent Health Palm Coast Parkway.
[AGENT][NEUTRAL] Thank you, and go ahead with that uh policy certificate or member ID number please.
[CUSTOMER][NEUTRAL] Member ID is
[CUSTOMER][NEUTRAL] 0194 0423.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And just give me one moment please to search that policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can I please have you verify the patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Yes, the patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you and for your claim status, can I please have the date of service and the amount on the claims for [PII] please.
[CUSTOMER][NEUTRAL] Um date of service is for [PII]. And the total bill is $17,199.19.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And just give me one moment to pull uh their claims history.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, just verifying that information of 11-23-2024.
[AGENT][NEUTRAL] Total charges built 17,199 and 19 cents.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I show we received that claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Claim process date is [PII]. Claim number is 3548.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 585.
[AGENT][NEUTRAL] And just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We made a benefit payment of $250.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Check number 20.
[AGENT][NEUTRAL] 21
[AGENT][NEUTRAL] Excuse me, 709.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so, um, the claim number just reconfirm it's 354-858-5, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. And uh is there any patient responsibility?
[AGENT][NEUTRAL] We did not determine the patient responsibility. This is a limited, uh, medical supplemental benefit plan.
[AGENT][NEUTRAL] Uh, so it works hand in hand with that major medical to cover the co-insurance and or deductible amounts for services covered under the plan up to their benefit maximum.
[CUSTOMER][NEUTRAL] OK. So the payment made was for $250.
[AGENT][NEUTRAL] Yes, and that was uh a maximum amount allowed.
[CUSTOMER][NEUTRAL] OK. And um when was the payment made, the check?
[AGENT][NEUTRAL] [PII] was the issue date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I showed the payment went to Advent Health [PII] at [PII].
[CUSTOMER][NEUTRAL] OK, thank you for that. And um we haven't received the EOB for this. So can you please send us the EOB?
[AGENT][NEUTRAL] Well, it wouldn't have made it to you just yet since it was finalized on the [PII].
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I can um
[AGENT][NEUTRAL] I can send it to you.
[AGENT][NEUTRAL] Um, do you have a fax number I can fax it to [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes. Yes. The fax number is going to be
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] 445
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] OK. That's 4452780143.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And to your attention?
[CUSTOMER][NEUTRAL] That would be [PII] and that would be claims.
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, did you have any other questions, [PII]?
[CUSTOMER][POSITIVE] No, only this one. Thank you so much. And can you please give me a reference number?
[AGENT][NEUTRAL] Certainly the call reference number would be my name and today's date.
[AGENT][NEUTRAL] And my first name
[CUSTOMER][NEUTRAL] OK. And uh can you please spell out? Yeah.
[AGENT][NEUTRAL] Yeah, my first name.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Last initial is [PII] like love and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII].
[AGENT][POSITIVE] You're welcome, [PII]. Thank you for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. Bye-bye. Same to you.
[AGENT][POSITIVE] Bye bye thank you bye bye.