AccountId: 011433970860
ContactId: bc1cb28d-1dfb-41f6-95df-67bc77ef44ee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 430899 ms
Total Talk Time (AGENT): 157106 ms
Total Talk Time (CUSTOMER): 181925 ms
Interruptions: 2
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/bc1cb28d-1dfb-41f6-95df-67bc77ef44ee_20250225T18:35_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] right
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I'm calling on behalf of Florida Mercy Hospital trying to check claim status.
[AGENT][NEUTRAL] OK, you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. I'm so sorry, what was your first name again, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] Uh, give me just one second.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Just one.
[AGENT][NEUTRAL] OK, and what is that member's policy number, please?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The member's policy number is 247-887-77.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh
[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 date of birth?
[CUSTOMER][NEUTRAL] Yeah, patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Data service is [PII]. Give me one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, [PII] until [PII] with the bill amount of $11,506 even.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Give me just a moment, please.
[CUSTOMER][NEUTRAL] Mhm. 60439844101.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah I do.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] It's just for myself.
[AGENT][NEUTRAL] OK, so I do show that this claim was received [PII], processed on [PII].
[CUSTOMER][NEUTRAL] Let me start.
[AGENT][NEUTRAL] The claim number is 3541502.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $1,585.49.
[AGENT][NEUTRAL] That was paid on single check [PII].
[AGENT][NEUTRAL] And the remark on this explanation of benefits states that with the payment of this check, the policy maximum for this benefit has been met.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] You said claim number is 3541502?
[AGENT][POSITIVE] Yes ma'am, that is correct.
[CUSTOMER][NEUTRAL] And it was received on [PII] and claim was processed on [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] That is correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] All right, and there's a payment amount of.
[CUSTOMER][NEUTRAL] $1,585.49 that was paid in a single check in [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Mhm, that is correct.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] All right. Do you know if it was paid with the, yeah.
[AGENT][NEUTRAL] And if you are
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Do you know if it was paid uh via check or EFT?
[AGENT][NEUTRAL] Yes, ma'am. I, I explained it was a single check and I gave you the check number.
[CUSTOMER][POSITIVE] Alright, could you repeat the check number for me? I'm so sorry.
[AGENT][NEUTRAL] Do you need from me?
[AGENT][NEUTRAL] That's OK, 201.
[AGENT][NEUTRAL] 852 1.
[AGENT][NEGATIVE] And this check does not show that it has cleared at this time.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Can you verify the address?
[CUSTOMER][NEUTRAL] Do you think you confirm you could confirm the, the address, yes, please.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Go ahead with what they confirm the address.
[CUSTOMER][NEUTRAL] Yeah, the address is [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That is correct. That is where this check was mailed to.
[CUSTOMER][NEUTRAL] OK, you know
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, it's a minus.
[CUSTOMER][NEUTRAL] Um, since it's been more than.
[CUSTOMER][NEUTRAL] More than a month since the check was uh issued, is it possible?
[AGENT][NEUTRAL] Yes, I can send a request. Yes, I will send a request to verify that it is indeed still outstanding and request authorization to void and reissue.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] And again, and if you need a copy of this explanation of benefits, [PII], in the meantime you can get our portal to print that. Our portal website is [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Thank you so much, uh, [PII].
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You're certainly welcome. Is there
[CUSTOMER][NEUTRAL] And do you think, yeah, thank you. Do you think you give me the call reference number? It's all right.
[AGENT][NEUTRAL] Uh-huh, sorry.
[AGENT][NEUTRAL] You would use my name along with today's date.
[CUSTOMER][POSITIVE] Alright perfect thank you so much hope you have a lovely day.
[AGENT][POSITIVE] Well, I hope you do too, [PII] if that's all I can help you with, thank you again for calling APL.
[AGENT][NEUTRAL] Bye-bye.