AccountId: 011433970860
ContactId: e9c7b564-fcd4-48a3-a49f-1de6104b3f49
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 504750 ms
Total Talk Time (AGENT): 100901 ms
Total Talk Time (CUSTOMER): 115978 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/e9c7b564-fcd4-48a3-a49f-1de6104b3f49_20250319T15:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, sorry, I'm [PII] calling from provider's office.
[AGENT][NEUTRAL] Hi [PII].
[AGENT][NEUTRAL] Um, can I get your callback number, please?
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] Sure. That would be [PII].
[AGENT][NEUTRAL] OK and what is the name of the provider's office you're calling from?
[CUSTOMER][NEUTRAL] AdventHealth, of course.
[AGENT][NEUTRAL] OK, and how can I help you today, [PII]?
[CUSTOMER][NEUTRAL] Uh, please, please.
[AGENT][NEUTRAL] I'm sorry, can you repeat that?
[CUSTOMER][NEUTRAL] Claim status.
[AGENT][NEUTRAL] Claim status. OK, thank you. And can you uh please spell the name of your facility for me, Miss [PII]?
[CUSTOMER][NEUTRAL] Sure. Uh the first name would be [PII] The next one would be um [PII] and the last word would be [PII]
[AGENT][NEUTRAL] OK, thank you. And then what is the um patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] The patient's policy number would be 0194404, sorry, I'll just repeat that again. It's 01940423 and then my first name would be [PII] and the date of birth would be [PII].
[AGENT][NEUTRAL] OK. Let me look up that policy real quick.
[AGENT][NEUTRAL] OK, thank you and then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] The date of service was [PII] and the charge amount would be,762 dollars 52 cents.
[AGENT][NEUTRAL] OK, and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] OK, just
[CUSTOMER][NEUTRAL] It's $70.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim and I will be right back.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me. I have the claim for you. The claim number is 3562282.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim was denied because the maximum benefit for that day has been met.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, may I know, was it, uh, exhaustion in terms of benefits, I mean in terms of units or the dollar amount?
[AGENT][NEUTRAL] It does $1 amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, uh, how much dollar amount does it exceed?
[AGENT][NEUTRAL] I'm sorry, repeat the question.
[CUSTOMER][NEUTRAL] Like how much uh amount does the patient like exhausted.
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] $500.
[AGENT][NEUTRAL] I'm sorry, I, I apologize. That was for inpatient. Outpatient is $250.
[CUSTOMER][NEUTRAL] OK, just a moment.
[CUSTOMER][NEUTRAL] OK. May I know the other benefits exhausted uh with this claim or during the previous claim?
[AGENT][NEUTRAL] And this is just to verify benefits. It's not a guarantee of payment. It was done on a previous claim. Each occurrence has to have a 90 day period in between occurrences.
[CUSTOMER][NEUTRAL] OK, uh, may I know the previous account number? Like it got exhausted from previous account, right?
[AGENT][NEUTRAL] I'm sorry I can't give you that information, that's private information.
[CUSTOMER][NEUTRAL] OK, just so.
[CUSTOMER][NEUTRAL] At least, uh, now the claim number and uh the processing of that lien.
[AGENT][NEUTRAL] No, I'm not gonna give you the.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Uh hello, are you there?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] to
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Are you there? Hello?
[CUSTOMER][NEUTRAL] To