AccountId: 011433970860
ContactId: f04db1de-788a-4144-9f63-bb58acff8f19
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 341820 ms
Total Talk Time (AGENT): 113190 ms
Total Talk Time (CUSTOMER): 88088 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/f04db1de-788a-4144-9f63-bb58acff8f19_20250219T21:26_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office to check the claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's the name of the provider or facility you're calling from?
[CUSTOMER][NEUTRAL] HCF Florida University Hospital.
[AGENT][NEUTRAL] OK, thank you. And may I have uh the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Yes, 0169989 ML 8.
[AGENT][NEUTRAL] Thank you. One moment, let me pull this information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, that's not what I pulled. Can you repeat that number one more time?
[AGENT][NEUTRAL] Ms. [PII], can you repeat that number? That's not who I pulled. 013, mhm.
[CUSTOMER][NEUTRAL] 016
[CUSTOMER][NEUTRAL] 013.
[CUSTOMER][NEUTRAL] 0130 01699895 ML ML 8.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I.
[AGENT][NEUTRAL] OK, can you repeat the date of birth one more time?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. May I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yes, date of service is from [PII] and the bill amount is $45,935.
[AGENT][NEUTRAL] Now it's [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me check and see if I have that claim and for future you can check claim status online through our website at [PII] and that's just optional. And let me pull this EOB one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, the claim was received [PII], processed [PII], and the claim was denied stating that the service was rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] What is the process date?
[CUSTOMER][NEUTRAL] May
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What should we do for the next step?
[AGENT][NEUTRAL] OK, the policy is terminated.
[AGENT][NEUTRAL] You might want to check and see if you have any other policies, but right now the policy with us is terminated. There's no other policies with us.
[CUSTOMER][NEUTRAL] Monday.
[CUSTOMER][NEUTRAL] Is, uh, what is the effective date, please?
[AGENT][NEUTRAL] Yes, the effective date is [PII] and it terminated [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Mhm, correct.
[CUSTOMER][NEUTRAL] OK. And there is no other coverage. There is no other insurance?
[AGENT][NEUTRAL] No other policies with us, no.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Do you need any other information?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment, please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can you spell out your name, please?
[AGENT][NEUTRAL] Sure. That's [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, thank you. And can I get the call reference number, please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK. Thank you so much for providing the information. Have a nice day. Thank you.
[AGENT][POSITIVE] You're welcome. You as well. Thank you for calling ATL. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah