AccountId: 011433970860
ContactId: e5eff243-12fc-4193-bfe1-77bcc37790f2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 380660 ms
Total Talk Time (AGENT): 153490 ms
Total Talk Time (CUSTOMER): 92239 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/e5eff243-12fc-4193-bfe1-77bcc37790f2_20250529T18:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, [PII]. My name is [PII]. I'm calling from AdventHealth today. I am calling in reference to a claim status for a patient, please.
[AGENT][POSITIVE] Sure, I can help you with claim status.
[AGENT][NEUTRAL] Can I get a good callback number in case we get disconnected, [PII]?
[CUSTOMER][NEUTRAL] Yes, it is [PII]. That is a direct line.
[CUSTOMER][NEUTRAL] And I'm sorry your name went right, [PII].
[AGENT][NEUTRAL] [PII], yes ma'am.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 369-762 Mike Lima 7
[AGENT][NEUTRAL] OK one moment while I look that up for you.
[AGENT][NEUTRAL] Can I get you to verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, of course. It is [PII] [PII]. That is the guarantor, I do apologize, the patient is.
[CUSTOMER][NEUTRAL] I came [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] And do you have the claim number or date of service?
[AGENT][NEUTRAL] Oh, hold on one.
[CUSTOMER][NEUTRAL] Date of service 2-16-2020. I'm sorry.
[AGENT][NEUTRAL] Um, no, go ahead. 216 of this year.
[CUSTOMER][NEUTRAL] [PII]. Yes, and for $54.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEUTRAL] Accidentally exited out. So give me just a moment. I apologize.
[CUSTOMER][POSITIVE] Oh, that's OK. I do it all the time.
[AGENT][NEUTRAL] I was trying not to sneeze and I guess I did something.
[CUSTOMER][NEUTRAL] Girl, don't hold back them sneezes.
[AGENT][NEUTRAL] All right, and you said it was for uh.
[AGENT][NEUTRAL] [PII], correct?
[CUSTOMER][NEUTRAL] Yes, [PII]
[AGENT][NEUTRAL] OK, let me check something real quick.
[AGENT][NEUTRAL] It looks like the policy number um is a lapsed policy. Would you like their, um, because I wasn't showing any claims on file for that date of service under that policy number. Would you like me to give you their updated policy number?
[CUSTOMER][POSITIVE] Oh, absolutely.
[AGENT][NEUTRAL] It's 251.
[AGENT][NEUTRAL] 8203.
[AGENT][NEUTRAL] And let me see if it got filed under this one instead.
[CUSTOMER][NEUTRAL] Now I show when we sent it, it was under the old one.
[AGENT][NEUTRAL] And you said it was for, I'm sorry, 50.
[CUSTOMER][NEUTRAL] $54 even.
[AGENT][NEUTRAL] $54. OK, give me just a moment.
[AGENT][NEUTRAL] And um it was for AdventHealth.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, tax ID [PII].
[AGENT][NEUTRAL] OK, I have that as Florida Hospital. Um, I am showing that we received that. OK, OK.
[CUSTOMER][NEUTRAL] That's the same, yeah, that's the same people.
[AGENT][NEUTRAL] I am showing that that claim, uh, I have the claim number as well for you if you would like.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Oh, abs let me see.
[AGENT][NEUTRAL] You said it was for 2-16-2025, OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, go ahead with the claim number.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] It is 35.
[AGENT][NEUTRAL] 91
[AGENT][NEUTRAL] 988. We received that claim on [PII]. It was processed on [PII].
[AGENT][NEUTRAL] It looks like that claim was denied because we need the a copy of the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then can that be faxed or does it need to be mailed, or how does that?
[AGENT][POSITIVE] Yes, ma'am, you can fax it.
[AGENT][NEUTRAL] Do you have our fax number or would you like me to give it to you?
[CUSTOMER][NEUTRAL] And a fax.
[CUSTOMER][NEUTRAL] I do not have a fax number. Go ahead.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] [PII]. And you can include that claim number that I gave you and the new policy number. It looks like they did file it under this the newer policy.
[CUSTOMER][NEUTRAL] OK perfect and can I get a reference number please?
[AGENT][NEUTRAL] OK, so we don't have call reference numbers, but you can use my name and last initial in today's date. So [PII], and today's date.
[CUSTOMER][POSITIVE] Beautiful thank you so much you have a great rest of your day.
[AGENT][POSITIVE] Great, thank you for calling APL and have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.