AccountId: 011433970860
ContactId: cc908b6c-517f-40e3-8843-7fe4d4b69d1d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 348029 ms
Total Talk Time (AGENT): 123540 ms
Total Talk Time (CUSTOMER): 169586 ms
Interruptions: 3
Overall Sentiment: AGENT=1.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/cc908b6c-517f-40e3-8843-7fe4d4b69d1d_20250206T14:11_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. So, uh, I'm calling from uh Baptist Hospital. How are you today?
[AGENT][POSITIVE] I'm good, thank you. How about you?
[CUSTOMER][POSITIVE] Good, thank you. Um, I wanted to ask you, um,
[CUSTOMER][NEGATIVE] Oh, I just lost the case.
[CUSTOMER][NEUTRAL] 186
[CUSTOMER][NEUTRAL] OK, um, wanted to ask you for, uh, uh, check if you got received a claim please.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Oh sure, yes, I can assist you with claims. And may I have your name?
[CUSTOMER][NEUTRAL] 40524.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] My name is [PII]. I'm so sorry. I'm just going to. My name is [PII]. I'm calling from, uh, I, I have to start my day different today. It's not going. OK. My name is [PII] from Baptist Hospital of Miami.
[AGENT][POSITIVE] OK it's funny.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 6
[AGENT][NEUTRAL] All right. And may I have a callback number just in case we get disconnected, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Sure, sure, sure. Um [PII].
[AGENT][NEUTRAL] OK, thank you. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, um, the policy number is um
[CUSTOMER][NEGATIVE] Can't get anything today.
[CUSTOMER][NEUTRAL] One second, I, I know on top of that, everything is just going so slow. I pulled things up, nothing is coming up. One of those days. OK, yeah. 02, 1 of those days. So almost Friday, so, so.
[AGENT][NEUTRAL] It'll get better.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Oh boy.
[AGENT][NEUTRAL] Yeah,
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Yeah, I can't wait. OK. So here it is. 023178.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 25.
[AGENT][NEUTRAL] OK, let's we have.
[CUSTOMER][NEUTRAL] 02317825.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient, Miss [PII]?
[CUSTOMER][NEUTRAL] Sure. [PII]. Date of birth [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] Perfect. Thank you. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yes, and the date for this one is um
[CUSTOMER][NEUTRAL] [PII] and the amount is $8,922. We had a $300 balance that was sent to you guys.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, right.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] APL
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, um, let me check and see which one it is.
[CUSTOMER][NEUTRAL] Jesus.
[AGENT][NEUTRAL] What is the DX code on it, do you know?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, I don't, um, was there a problem with the with the code?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, no, I just have 2 for some reason to facility charges. So let me check and see which one is it.
[AGENT][NEUTRAL] Usually it's not 2, so that's weird.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] I kind of here but I think it itself.
[AGENT][NEUTRAL] Let me check this other one.
[CUSTOMER][NEGATIVE] My mouth fell under there.
[CUSTOMER][NEUTRAL] OK. So the diagnosis code, you're saying that um let me look if I see it. One second.
[AGENT][NEUTRAL] OK, I found it.
[CUSTOMER][NEUTRAL] Um, you found it? OK, cause I have to go somewhere else and.
[AGENT][POSITIVE] Yes, I do
[AGENT][NEUTRAL] It's OK, I found it. Alright, so it looks like this one was processed on [PII] and uh we send a benefit amount of $176.24. That was the remaining outpatient maximum benefit, um, so with that payment, the maximum has been exhausted.
[CUSTOMER][NEUTRAL] OK. So the, the, you only paid 126, 24?
[AGENT][NEUTRAL] 17624.
[CUSTOMER][NEUTRAL] OK. 176. I'm sorry. Perfect. All right, no problem. And uh maxima. And is there a claim number, please?
[AGENT][NEUTRAL] Mhm. Yes, OK. Mhm.
[AGENT][NEUTRAL] Yes, the claim number is 3557969.
[CUSTOMER][NEUTRAL] And um is there a check number please [PII]?
[AGENT][NEUTRAL] Yes, 202-5203.
[CUSTOMER][NEUTRAL] And when was the check sent? Oh, you did say [PII], right?
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][POSITIVE] OK, perfect. OK, great. I thank you so much today for your help. So have a great day.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You as from [PII], and thank you for calling APL and it's gonna get better.
[CUSTOMER][POSITIVE] Yeah, thank you. Yes, yes, I know it will. Yes. Thank you so much. Have a great day. Talk to you later. Thank you. Mhm. All right, bye-bye.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You're welcome. You too, Miss [PII]. All right, bye bye. Bye.