AccountId: 011433970860
ContactId: 4cc06bf6-84ce-42fd-bc30-46582ba0b83e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 536960 ms
Total Talk Time (AGENT): 115116 ms
Total Talk Time (CUSTOMER): 171513 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/4cc06bf6-84ce-42fd-bc30-46582ba0b83e_20250206T20:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office. Could you please help me with the claim status?
[AGENT][NEUTRAL] OK, yes ma'am, I can help you with the claim status. [PII], what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Uh, sure. It's going to be [PII]. And is that the plan?
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's name?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] OK. And then what is the patient's date of birth?
[CUSTOMER][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] And the patient's policy number, please?
[CUSTOMER][NEUTRAL] Uh, so, 2505666.
[AGENT][NEUTRAL] OK, what was that again? 20250566.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, no, no, it's 250-566-2.
[CUSTOMER][NEUTRAL] 13 to 405.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] By the way, could you please spell your name and initials your last name, please?
[AGENT][NEUTRAL] Yes, it's [PII] and my last initial is [PII]
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] OK, thank you. And then what is the data service?
[CUSTOMER][NEUTRAL] Uh, it's 79 2024.
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] Uh, sure. The charges are $7,938.07. Maybe the tracking ID might help, we can try that.
[AGENT][NEUTRAL] OK, and then what is the charges after primary paid their part?
[CUSTOMER][NEUTRAL] Uh, well, the primary page, just a second.
[CUSTOMER][NEUTRAL] The primary paid $419.09.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so what is the charge after primary paid theirs?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Oh, the total charges are actually $7,938.07.
[AGENT][NEUTRAL] OK thank you and then what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Uh, it's Adventure Heart of Florida.
[AGENT][NEUTRAL] OK. I'm gonna put you on a brief hold while I look up this claim for you, Ms. [PII], I'll be right back.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] Yeah, sure. Sure. You are on hold.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Come on.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], this is [PII] back with you again. So I do have the claim pulled up and the claim number is 348988887.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Uh, uh, it's
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah. Mhm.
[AGENT][NEUTRAL] The claim was denied because the benefit for the calendar year has been met.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim was received on.
[CUSTOMER][NEUTRAL] OK, so yeah.
[AGENT][NEUTRAL] [PII] and was processed.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The department just mentioned my
[AGENT][NEUTRAL] I'm sorry, the claim was received on.
[CUSTOMER][NEUTRAL] Si.
[AGENT][NEUTRAL] [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] OK, so just to confirm, OK, got it. Uh, well, could you please fax us the EOB?
[AGENT][NEUTRAL] Yes, I can. Um, can I get your fax number?
[CUSTOMER][NEUTRAL] Uh, sure. [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I get that faxed over to you. I'll be right back.
[CUSTOMER][NEGATIVE] Yeah, sure. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thanks for holding, [PII]. I've got that fax on its way to you now.
[CUSTOMER][NEUTRAL] OK. Uh just to confirm, your name is spelled as [PII] That's it?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, got it. Thank you so much. And the caller friend?
[AGENT][NEUTRAL] Is my name and today's date.
[CUSTOMER][NEUTRAL] OK, got it. So how much time should be allowed to receive the UV?
[AGENT][NEUTRAL] You just have to give it a chance to come through the fax line.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, got it. Uh, just to confirm, you have this fax number, right? [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Got it. Uh, well, thank you so much for helping with the claim status and have a great day. Bye for now.
[AGENT][POSITIVE] Bye-bye, [PII]. Thank you. You have a great day also. Thanks for calling ATL.
[CUSTOMER][NEUTRAL] Yeah, bye.
[AGENT][NEUTRAL] Bye bye