AccountId: 011433970860
ContactId: c2b9d011-a557-41a2-9f5e-5bf21079b7ef
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 269989 ms
Total Talk Time (AGENT): 89310 ms
Total Talk Time (CUSTOMER): 113654 ms
Interruptions: 1
Overall Sentiment: AGENT=1.9, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/c2b9d011-a557-41a2-9f5e-5bf21079b7ef_20250225T19:05_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello [PII]. Good afternoon. This is [PII] calling from the Better office, and this call is regarding to know a claim status or bill status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the claim status and from my notes, can you spell your first name for me, please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] My initial is [PII].
[AGENT][POSITIVE] Thank you for that, and [PII], what's a good contact number for you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII], a direct line?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, uh, just a second, it's uh 021 7.
[AGENT][NEUTRAL] [PII], I'm sorry, yes.
[CUSTOMER][NEUTRAL] Uh, sorry, I'll repeat. Yeah, yeah. Um, yeah, 02175341, M as in Mary, L as in Lima, number 8.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII]. [PII].
[AGENT][POSITIVE] Thank
[AGENT][POSITIVE] Thank you for that.
[CUSTOMER][NEUTRAL] D of services. Mhm.
[AGENT][NEUTRAL] Hold on one moment. All the information provided is a verification of benefits, not a guarantee of payment. And what was the date of service and the total bills?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[CUSTOMER][NEUTRAL] And let me cross check the bill amount.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, it's uh.
[CUSTOMER][NEUTRAL] Oh my gosh. It's $14,758 and even.
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] HC Florida Mercy Hospital.
[AGENT][NEUTRAL] Alright, so I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 34738778.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Needed, OK. May I know who is the primary insurance?
[AGENT][NEUTRAL] Um, hold on one moment.
[AGENT][NEUTRAL] UnitedHealthcare.
[CUSTOMER][NEUTRAL] Can I get a policy ID?
[AGENT][NEUTRAL] Uh, we don't have the information. We don't have the policy. Go ahead.
[CUSTOMER][NEUTRAL] Sorry, if you
[CUSTOMER][NEUTRAL] Uh, do you have
[CUSTOMER][NEUTRAL] Yeah, I'm extremely sorry. Uh, I just need the effective date. I have a policy ID.
[AGENT][NEUTRAL] We don't have any of the policy information, we only have the name.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. So for this one, can you please provide me your mailing address or fax number so we can send you the primary UOB.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Fax number?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much, just a second.
[CUSTOMER][POSITIVE] And so yeah, that's it from my side. Thank you so much for assisting me today. Can I get a reference number for today's call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII], for providing me this information. That's it from my side. Thank you so much. Have a wonderful day. Bye.
[AGENT][POSITIVE] All right. Well, thanks
[AGENT][POSITIVE] Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Oh