AccountId: 011433970860
ContactId: c0cd1e1b-bf05-4a2d-acf0-c050d9bbc1c7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 338320 ms
Total Talk Time (AGENT): 93423 ms
Total Talk Time (CUSTOMER): 101632 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/c0cd1e1b-bf05-4a2d-acf0-c050d9bbc1c7_20250106T17:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. I'm calling from University of Miami Hospital and Clinics. And I'm trying to get status on a medical claim for a patient. Will you be able to help me?
[AGENT][NEUTRAL] Yes [PII], I can help you with the claim status. Can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] Thank you. And then what's the patient's name?
[CUSTOMER][POSITIVE] So I'm so sorry. Say it again.
[AGENT][NEUTRAL] The patient's name?
[CUSTOMER][NEUTRAL] It is [PII], I'll spell it is [PII] is the last name and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's policy number?
[CUSTOMER][NEUTRAL] 1349433 M for Mary, L for Lima, 8.
[AGENT][NEUTRAL] OK, thank you and then what's the date of service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The data service in question is [PII]. Bill amount $31,498.
[AGENT][NEUTRAL] Thank you and then what's the charge after primary paid their part?
[CUSTOMER][NEUTRAL] OK. Let me see here. Well, the balance on what we have here is $4,458.37.
[AGENT][NEUTRAL] OK. And you said you're with the University of Miami?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, alright, Miss [PII], I'm gonna put you on a brief hold while I look up that claim for you and I'll be right back.
[CUSTOMER][POSITIVE] Perfect. Thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi, Ms. [PII], this is [PII] back with you again.
[AGENT][NEUTRAL] So looking at the claim, the claim number is 354383.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] I'm so sorry. You cut off. You, you're cutting off. What is it?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] 3543843
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] And I was denied because the um maximum benefit payable for that data service had been met.
[CUSTOMER][NEUTRAL] 9 max benefit.
[CUSTOMER][NEUTRAL] Was met. OK. And when did you guys mailed already the, the EOB?
[CUSTOMER][NEGATIVE] Uh, cause we haven't received nothing.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] It was not so to allow time then.
[AGENT][NEUTRAL] Now I can send
[AGENT][NEUTRAL] Right. I can, I can, um, let me see what day.
[AGENT][NEUTRAL] It was mailed out on [PII].
[CUSTOMER][NEUTRAL] OK, cause I don't, they haven't posted anything yet here. So I guess we will wait and see and if there's, uh-huh.
[AGENT][NEUTRAL] Um, let.
[AGENT][NEUTRAL] Also I wanted to let you know that the um policy number that you gave me was a lapsed policy. Let me give you the correct policy number so you have that for your files.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 01.
[AGENT][NEUTRAL] 6
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 985 5.
[CUSTOMER][POSITIVE] Perfect. Thank you so much.
[AGENT][POSITIVE] You're very welcome. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] OK. Bye-bye.