AccountId: 011433970860
ContactId: 68293ba4-61bb-44a8-8ce0-efaed73d44a3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 263600 ms
Total Talk Time (AGENT): 86437 ms
Total Talk Time (CUSTOMER): 100447 ms
Interruptions: 2
Overall Sentiment: AGENT=1.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/68293ba4-61bb-44a8-8ce0-efaed73d44a3_20250605T18:15_UTC.wav
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[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is An[PII]How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hello An[PII]my name is Je[PII]and I'm calling from the business office of Palm Beach Garden Medical Center to check for claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status and just may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 46[PII]
[AGENT][NEUTRAL] [PII]hank you. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 02584690
[AGENT][NEUTRAL] And that was 258-465-0?
[CUSTOMER][NEUTRAL] Yes, uh, sorry, 02584690.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 90. OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Ai[PII].
[CUSTOMER][NEUTRAL] Ju[PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And how many claims do you have in total today, Je[PII]?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, only one.
[AGENT][NEUTRAL] All right, and
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on one moment. May I have the date of service and the total bills?
[CUSTOMER][NEUTRAL] Uh, Ma[PII]ith $3,368 even.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Well it's it.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Alright, so I'm showing the claim was received on Ap[PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The claim number is 358.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 865 9.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And on February, I'm sorry, on Ap[PII]the claim was denied.
[AGENT][NEUTRAL] Because the claim submission shows as an accident or injury, but the policy only covers sickness.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So we need to send the claim to the uh auto insurance or?
[CUSTOMER][NEUTRAL] Or any uh
[CUSTOMER][NEUTRAL] We need to build this claim to a different insurance since it was an accident, right?
[AGENT][NEUTRAL] Um, I'm not sure what your next steps would be. We're just saying for this policy, it doesn't cover accidents and injury.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Alright, may I have the call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. Again, my name is An[PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Alright, thanks so much for your help, An[PII]and have a good day.
[AGENT][POSITIVE] You also, was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] Uh, no more, thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL. Have a great day.