AccountId: 011433970860
ContactId: 64da0c87-b5e1-4acf-a47b-5eb05e38680f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 257428 ms
Total Talk Time (AGENT): 67506 ms
Total Talk Time (CUSTOMER): 161646 ms
Interruptions: 5
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/64da0c87-b5e1-4acf-a47b-5eb05e38680f_20250429T20:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII], this is [PII] calling from University of Miami to check on a claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status. I missed your name. What was your name?
[CUSTOMER][NEUTRAL] My name will be [PII]
[AGENT][NEUTRAL] OK, and your callback number, [PII], and I can help you with claim status.
[CUSTOMER][NEUTRAL] Yeah, it will be [PII] with the extension of [PII]. By the way, how are you doing today, [PII]?
[AGENT][POSITIVE] Doing good. How are you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, good to hear that. Thank you for asking. Doing good as well.
[AGENT][NEUTRAL] Um, what's that policy number, [PII]?
[CUSTOMER][NEUTRAL] It will be 01622818.
[CUSTOMER][NEUTRAL] M as in Mike. L as in Larry, 8.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Member's first name will be?
[CUSTOMER][NEUTRAL] [PII], last name of the [PII], and date of birth will be [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And what was the date of service and bill charges?
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] It will be [PII] with a bill amount of $508 even.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] I can't do what I do one of them.
[AGENT][NEUTRAL] It looks like, let's see, you said $508 correct?
[CUSTOMER][NEUTRAL] Yeah I'm.
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Oh I I don't think it was.
[AGENT][NEUTRAL] Like that was received on 35-2025.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And we made a payment on 37-2025.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's $27.40.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And you need the check number?
[CUSTOMER][NEUTRAL] Uh, uh, it's a lot amount is a lot amount and paid amount is $27.40.
[CUSTOMER][NEUTRAL] Oh no no no they can.
[AGENT][NEUTRAL] Um, we just, the office visits not covered. 99203, it's not covered under the policy.
[AGENT][NEUTRAL] So we paid on the other services rendered paid 2740.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] a little
[CUSTOMER][NEUTRAL] Sorry, sorry, uh, just to confirm, you said the officer said is not covered, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So there's any payment done?
[AGENT][NEUTRAL] Just made the payment of 2740 on the other bill charges.
[CUSTOMER][NEUTRAL] Uh, you mean, uh, balance, so I mean balance CBD right? the other two CPDs.
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] For the other two CPTs, uh, the claim has been paid, right?
[AGENT][NEUTRAL] Yes, the 20,550 and J 0702.
[CUSTOMER][POSITIVE] Yeah, I got it.
[CUSTOMER][NEUTRAL] Yeah, I got it. No worries. Could you please send me a copy of UOB through fax, [PII]?
[AGENT][NEUTRAL] What's your?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And uh by the way, can I get the claim number?
[AGENT][NEUTRAL] Claim number is 3572988.
[CUSTOMER][NEUTRAL] It's a
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, perfect. Just to confirm you received the claim on [PII] and uh denied on [PII], as non-covered service, am I right?
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] OK, uh, just to confirm, office visitors, office visits are not covered under the member's plan.
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] It is my responsibility by the way?
[AGENT][NEUTRAL] We can't determine patient responsibility because we're a supplemental secondary policy.
[CUSTOMER][NEUTRAL] OK, got it. We will be assuming you'll be within the end of the day, right?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][POSITIVE] We will be receiving the EOB within the end of the day or within the next 24 business hours, right?
[AGENT][NEUTRAL] No, I'll send it in 5 minutes.
[CUSTOMER][POSITIVE] I got it, thank you for that.
[CUSTOMER][POSITIVE] Thank you, [PII]. It's been a pleasure talking with you. I hope you have a great day. Take care. Bye-bye.
[AGENT][POSITIVE] Thanks for calling APL you as well. Bye bye.
[CUSTOMER][NEUTRAL] Uh