AccountId: 011433970860
ContactId: 5f735bb3-16ea-41c4-a7ec-07797be65ca5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 875510 ms
Total Talk Time (AGENT): 176670 ms
Total Talk Time (CUSTOMER): 179857 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/5f735bb3-16ea-41c4-a7ec-07797be65ca5_20250506T22:13_UTC.wav
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[AGENT][POSITIVE] Thank you for calling AP.
[AGENT][NEUTRAL] Oh, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] here calling from provider's office checking on online status.
[AGENT][NEUTRAL] OK [PII], I can help you with claim status, ma'am. Can I please get your callback number just in case the call gets disconnected?
[CUSTOMER][NEUTRAL] Is it [PII], no extension.
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth is [PII]. And the policy number is 02448967 M as in Mike L as in Lima, number 7.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, may I please have the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Sure. Date of service here is.
[CUSTOMER][NEUTRAL] [PII] with the total charge of $46,699.56.
[AGENT][NEUTRAL] Thank you and then what's the
[AGENT][NEUTRAL] Charge out after the primary insurance paid their part.
[CUSTOMER][NEUTRAL] It is $200. And what is your good name, please?
[AGENT][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] And then can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure it's Florida Kendal Hospital.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, Miss [PII].
[AGENT][NEUTRAL] While I look up this claim and I'll be right back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you Miss [PII] for holding for me. I have the claim for you. The claim number is 35.
[AGENT][NEUTRAL] 96.
[AGENT][NEUTRAL] 177.
[AGENT][NEUTRAL] The claim was denied because the inpatient benefit amount for the calendar year has been met.
[CUSTOMER][NEUTRAL] Ah, but
[CUSTOMER][NEUTRAL] What's the claim number again?
[AGENT][NEUTRAL] 359-617-77
[CUSTOMER][NEUTRAL] What's the received and processed date?
[AGENT][NEUTRAL] Let me look that up for you real quick.
[AGENT][NEUTRAL] We received it on.
[AGENT][NEUTRAL] [PII] and processed it on [PII].
[CUSTOMER][NEUTRAL] What's the name again?
[AGENT][NEUTRAL] The inpatient calendar year benefit has been met, maxed out.
[CUSTOMER][NEUTRAL] So as maximum benefits existed?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Just a second here.
[CUSTOMER][NEUTRAL] So is the whole bill amount is the patient's responsibility?
[AGENT][NEGATIVE] We do not give patient responsibility.
[CUSTOMER][NEUTRAL] OK. And can you please send me the copy of your via fax?
[AGENT][NEUTRAL] Yes, what is your fax number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Attention, patient control number.
[CUSTOMER][NEUTRAL] Which is [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold again Miss [PII], while I get that EOB ready for you and I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me I have that email I'm sorry, I have that fax on its way to you now.
[CUSTOMER][NEUTRAL] OK. And I just want to check one more claim and what is the call reference number for this one?
[AGENT][NEUTRAL] Both of them is gonna be my name and today's date.
[CUSTOMER][NEUTRAL] Can I proceed with the next one?
[AGENT][NEUTRAL] Yes, what is the next patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes. Just give me a quick second here. Let me finish this off.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] The next patient.
[CUSTOMER][NEUTRAL] The next patient name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII]. Policy number is 01043757.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK and then what is the data service?
[AGENT][NEUTRAL] The charge amount
[CUSTOMER][NEUTRAL] Sure. The date of service is number [PII] and the charge amount is $1,986.48.
[AGENT][NEUTRAL] OK. And is it for the same hospital?
[CUSTOMER][NEUTRAL] No, it's for Center Point Medical Center.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold again while I look this one up and I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me [PII]. So looking on this data service of [PII] for Jan, I do not find a claim on file.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] OK. What's the mailing address?
[AGENT][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] What is the [PII] number again?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a second here.
[CUSTOMER][NEUTRAL] What's the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] One Plan type?
[AGENT][NEUTRAL] Hospital indemnity.
[CUSTOMER][NEUTRAL] Family.
[AGENT][NEGATIVE] We do not have a timely filing limit.
[CUSTOMER][NEUTRAL] Effective on termination date.
[AGENT][NEUTRAL] Effective date is [PII] and the policy is still active and current.
[CUSTOMER][NEUTRAL] Group name
[AGENT][NEUTRAL] Spectrum Home Health.
[CUSTOMER][NEUTRAL] What's the Spectrum Home Health?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And the group number?
[AGENT][NEUTRAL] 13,520.
[CUSTOMER][NEUTRAL] Insurance name is American Public Life, right? APL.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh just a second here.
[CUSTOMER][NEUTRAL] So, can you please verify the patient's address for me?
[AGENT][NEUTRAL] The patient's address?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, that's personal information. I can't give that out.
[CUSTOMER][NEUTRAL] Can I provide that to you? Can you please confirm that?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK. And the call reference number will be your name and today's date, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK then thank you so much for your assistance, [PII]. Have a great day. Bye for now.
[AGENT][POSITIVE] You too you have a wonderful night and thank you for calling APL bye bye.