AccountId: 011433970860
ContactId: b711348c-f36d-4dd5-9b48-e3f597c6ddb1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260149 ms
Total Talk Time (AGENT): 127475 ms
Total Talk Time (CUSTOMER): 83186 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/b711348c-f36d-4dd5-9b48-e3f597c6ddb1_20250421T17:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm sorry, what is your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I'm calling regarding a claim.
[AGENT][NEUTRAL] OK, I can check on a claim for you. [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And [PII], is this for your individual policy or are you with a provider?
[CUSTOMER][NEUTRAL] This is from Boca Raton Regional Hospital. I'm calling regarding one of our patients.
[AGENT][NEUTRAL] Got it, thank you. Do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, I do. The policy number is going to be 02477069.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that and what was the date of service for this client, please?
[CUSTOMER][NEUTRAL] [PII] for the amount of $806 even.
[AGENT][POSITIVE] Got it, thank you. One moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], was that the amount before or after major medical paid?
[CUSTOMER][NEUTRAL] No, that's the bill amount before any payment.
[AGENT][NEUTRAL] Got you. Do you happen to have that remaining balance?
[AGENT][NEUTRAL] After a major medical?
[CUSTOMER][NEUTRAL] The remaining balance was 7365.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have the tax ID by chance [PII]?
[CUSTOMER][NEUTRAL] The tax ID is [PII].
[AGENT][NEUTRAL] OK, so the only claim that I have for that date of service, um, it is through this provider that was for the amount of $220.97.
[CUSTOMER][NEUTRAL] OK, that's the payment that they made to us. That's the payment that that that is what the insurance paid towards the deductible.
[AGENT][NEUTRAL] OK, so that's the amount that we received and that we paid, so we paid a benefit of $220.97.
[CUSTOMER][NEUTRAL] And do you have a claim number?
[AGENT][NEUTRAL] Absolutely. That is 3573841.
[CUSTOMER][NEUTRAL] And when was that paid?
[AGENT][NEUTRAL] Give me just a moment. Did you need that check number as well?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can go ahead and give that to you. That is 20.
[AGENT][NEUTRAL] 32,320.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And give me one moment, I'll get that information.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So this check was issued on [PII].
[AGENT][NEUTRAL] And I am showing that this check.
[CUSTOMER][NEUTRAL] Was this sent to the number?
[AGENT][NEUTRAL] No, um, it was sent to, uh, [PII]. Is that correct?
[CUSTOMER][NEGATIVE] Uh, no.
[CUSTOMER][NEUTRAL] OK, yes, that is correct, yes, so we should have gotten it, OK.
[AGENT][NEUTRAL] OK, yes.
[AGENT][NEUTRAL] Yes, and I am showing that it did clear uh [PII].
[CUSTOMER][NEUTRAL] And what is the patient responsibility for this one?
[AGENT][NEUTRAL] Um, uh, honestly, this is all that we were billed for was for that amount, um, but either way we don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][POSITIVE] Oh, OK, OK, so, um, can you give me a reference number for this? Thank you so much.
[AGENT][NEUTRAL] Sure, yeah, that would just be my first name, last initial and today's date, and so my name is spelled [PII] And was there anything else I can help you with?
[CUSTOMER][NEUTRAL] What is initial
[CUSTOMER][POSITIVE] All right, thank you.
[CUSTOMER][POSITIVE] No, that will be all thank you [PII] have a wonderful day.
[AGENT][POSITIVE] All right, yeah, thanks for calling APL. You too. Bye bye.
[CUSTOMER][NEUTRAL] Bye.