AccountId: 011433970860
ContactId: e9f8a8e9-b8ac-42cf-8bed-8aad5ae20568
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215919 ms
Total Talk Time (AGENT): 107603 ms
Total Talk Time (CUSTOMER): 77031 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/e9f8a8e9-b8ac-42cf-8bed-8aad5ae20568_20250206T14:17_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling from AdventHealth. I was calling to get a claim status for one of the members.
[AGENT][POSITIVE] [PII], it would be my pleasure to help you with that claim status today. What is a good callback number?
[CUSTOMER][NEUTRAL] Um, that would be [PII] is the direct number.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Um, that will be 02509981.
[AGENT][NEUTRAL] And the patient's name and date of birth please, ma'am.
[CUSTOMER][NEUTRAL] Um, [PII], [PII].
[AGENT][POSITIVE] Alright, thank you, and it would be my pleasure to help you with that claim status. What is that data service?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] And the build out please, ma'am.
[CUSTOMER][NEUTRAL] Um, $382.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And what is the facility name?
[CUSTOMER][NEUTRAL] Um, the facility name it should be under Advent Health Medical Group.
[AGENT][NEUTRAL] Could it be Florida?
[CUSTOMER][NEUTRAL] For the hospital physician. Mhm.
[AGENT][NEUTRAL] Yeah, that's the one we have.
[CUSTOMER][POSITIVE] Yes, ma'am. You're welcome.
[AGENT][NEUTRAL] Thank you, [PII]. And we did receive that claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] And this claim was denied as office visits were not covered under the patient's plan.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] OK, so the office visits are not covered. Is it like um, what type of plan is this? Is it like a med like a medical plan or?
[AGENT][NEUTRAL] Yeah, this is her, it is, this is her secondary policy to her primary insurance.
[CUSTOMER][NEUTRAL] OK, and typically office visits aren't covered on that.
[AGENT][NEUTRAL] It just depends on what the um her employer is offering what type of policy we do have some that do cover office visits and some that don't.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Depends on what the insured is offered through her employer.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I got it. Thank you.
[AGENT][NEUTRAL] Now, would you like that claim number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] The claim number is 353.
[AGENT][NEUTRAL] 1851.
[CUSTOMER][POSITIVE] Alright, thank you so much for that. It's gonna be all the information I need.
[AGENT][POSITIVE] My pleasure to help you today?
[AGENT][POSITIVE] Well, [PII], it was a pleasure to assist you with that claim status. Do you need a reference number? I can help you with that.
[CUSTOMER][POSITIVE] Yes, thank you.
[AGENT][NEUTRAL] The reference number would be my name and today's date, and I spell my name [PII].
[CUSTOMER][POSITIVE] All right. Thank you so much for your time, [PII]. You have a good rest of your day.
[AGENT][NEUTRAL] Tomorrow.
[AGENT][POSITIVE] Oh thank you. I hope you have a wonderful day as well, and it was my pleasure to assist you. Take care and have a lovely day.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][NEUTRAL] Bye-bye.