AccountId: 011433970860
ContactId: 60ef2f1d-c39b-4001-9702-af65da4c4c00
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240300 ms
Total Talk Time (AGENT): 91421 ms
Total Talk Time (CUSTOMER): 42213 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/60ef2f1d-c39b-4001-9702-af65da4c4c00_20250227T14:45_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, good morning, my name is [PII]. I'm calling for Florida Medical Center. I'm trying to see if you have a claim on file.
[AGENT][NEUTRAL] OK, [PII], you're needing to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] I have 01792003 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] I have [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. And the date of service and total bill amount for her?
[CUSTOMER][NEUTRAL] 2524 through 229 24 bill amount 3,613 35 cents.
[AGENT][NEUTRAL] OK, that was 25 to 229. Is that correct?
[CUSTOMER][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, so this claim was received on [PII] and it was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 3436605.
[AGENT][NEUTRAL] And the reason for the denial on this claim?
[AGENT][NEUTRAL] States kinesiology, speech, or occupational therapy are not covered benefits under this policy.
[AGENT][NEUTRAL] And if you need a copy of this explanation of benefits, [PII], you may print that by going to our portal.
[AGENT][NEUTRAL] And our portal website is secured. [PII].
[CUSTOMER][NEUTRAL] OK, thank you. Is there a call reference number I can use?
[AGENT][POSITIVE] Yes, ma'am. You would actually use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] All right, that's all I needed then. Thank you so much.
[AGENT][POSITIVE] OK. Well, you are certainly very welcome. So if that is all I can help you with, thank you again for calling APL and I hope you have a great day, [PII].
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you. Bye