AccountId: 011433970860
ContactId: d7f68b2c-8927-4320-a214-8d6d9871bf98
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 373250 ms
Total Talk Time (AGENT): 118113 ms
Total Talk Time (CUSTOMER): 75299 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/d7f68b2c-8927-4320-a214-8d6d9871bf98_20250404T19:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes, my name is [PII], and I'm calling from Miami Beach Anesthesiology, and I'm calling to get status on a claim for one of our patients.
[AGENT][NEUTRAL] OK, I can help you with status, um, claim status, Ms. [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. What was the last four digits please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you so much. And then can you please give me the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, policy number is 02.
[CUSTOMER][NEUTRAL] 198456 M as in Mary, L as in Lima 8 and then the number 8. Patient name [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[AGENT][NEUTRAL] OK. And you're calling from Miami Anesthesia. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look up this claim and I will be right back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you, thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Actually I need to get the data service and the charge amount please.
[CUSTOMER][NEUTRAL] Um, yes, date of service [PII], and that charged amount was $900.
[AGENT][NEUTRAL] 900 even? OK, and then what was the charges after the primary paid?
[CUSTOMER][NEUTRAL] Um, let me go into that. Give me one minute.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] $606.80.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on a quick hold again and I will be right back with you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you very much for holding for me, Ms. [PII]. I have the claim pulled up for you. The claim number is 352-715-1.
[AGENT][NEUTRAL] And the claim was denied and let me read you the remark, um.
[AGENT][NEUTRAL] Uh, it's gonna be just a second. Let me get back where I was.
[AGENT][NEUTRAL] OK, the claim was denied and this is the remark that's on the claim on the EOB um, we have received the primary explanation of benefits that was submitted with your claim. However, the explanation of benefits received does not list the amounts applied to the deductible, co-pay or co-insurance. Please submit a more detailed explanation of benefits that shows these amounts for further consideration of your claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] OK, and do you have the information to send it to?
[CUSTOMER][NEUTRAL] I will go ahead and get
[CUSTOMER][NEUTRAL] Um, yes, I have the fax number where I can fax it to.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK awesome OK good deal.
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] Uh, nope, that'll be all.
[AGENT][POSITIVE] OK perfect you have a wonderful weekend and thanks for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye, ma'am.