AccountId: 011433970860
ContactId: f452ccd5-e8d9-49ea-99f8-48c11eb0e60e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 400000 ms
Total Talk Time (AGENT): 130434 ms
Total Talk Time (CUSTOMER): 114380 ms
Interruptions: 2
Overall Sentiment: AGENT=1.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/f452ccd5-e8d9-49ea-99f8-48c11eb0e60e_20250408T13:17_UTC.wav
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[CUSTOMER][NEUTRAL] I see that down down tempora.
[AGENT][NEUTRAL] Calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi [PII], can you give me one second please?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Give me a second please. I have another call on the line. Hold on.
[CUSTOMER][NEUTRAL] Give me a minute.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah, hi, can you hear me?
[AGENT][POSITIVE] I can. How can I help you today?
[CUSTOMER][NEUTRAL] Hi, yes, my name is [PII]. I'm calling from South Miami Hospital. I faxed over a claim to you guys, uh, with a UV and I need to know if it's in process or what's the status.
[AGENT][NEUTRAL] OK, so you're wanting
[CUSTOMER][NEUTRAL] What is your name, please?
[AGENT][NEUTRAL] Again, my name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], you're wanting to verify if the fax was received for a number?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes, I may have been they show your last name?
[AGENT][NEUTRAL] Yes and yours?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and your callback number please [PII].
[CUSTOMER][NEUTRAL] [PII]. South Miami Hospital.
[AGENT][POSITIVE] Thanks.
[AGENT][POSITIVE] Thank you. And
[AGENT][NEUTRAL] Yes, I can help you in checking to see if that was received. What is the patient's policy number, [PII]?
[CUSTOMER][NEUTRAL] 02496810.
[AGENT][NEUTRAL] Thank you. One moment please while I locate the um the member's information all pulled up please.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information provided would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII], uh [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And did you say your name, you, I wanna make sure I got your first name correct, [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what's the date of service and total bill amount like?
[CUSTOMER][NEUTRAL] It is [PII] for $3,503.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] OK, thank you
[CUSTOMER][NEGATIVE] Cause I looked online and I couldn't find it.
[AGENT][NEUTRAL] OK, um, so this claim was received. The received date was [PII], and it was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] There was a benefit that has been issued in the amount of $2,026.01.
[CUSTOMER][NEUTRAL] 2026.1 cent. Any patient responsibility?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] We do not determine patient.
[CUSTOMER][NEUTRAL] No, that's the amount.
[AGENT][NEUTRAL] That is the benefit that was made and
[CUSTOMER][NEUTRAL] No, no, no, I got it. And
[CUSTOMER][NEUTRAL] Um, I apologize. Give me a second.
[CUSTOMER][NEUTRAL] Can I have the claim number?
[AGENT][NEUTRAL] 3583402
[CUSTOMER][NEUTRAL] 35834002.
[AGENT][POSITIVE] That is correct. Yes, ma'am.
[CUSTOMER][POSITIVE] OK, I'm sorry you were saying I am sorry for the interruption.
[AGENT][NEUTRAL] I'm not sure what I was saying that to pay.
[CUSTOMER][NEUTRAL] OK, you and you were telling me that it paid the amount that pay and what is the check number?
[AGENT][NEUTRAL] 2036498
[CUSTOMER][NEUTRAL] OK. And when was it um mail?
[AGENT][NEUTRAL] And if you need a copy?
[AGENT][NEUTRAL] OK, the check was issued the same day as the process date, and it would have mailed the next day unless that was on a Friday and then it would have mailed in on Monday.
[CUSTOMER][NEUTRAL] OK, so it was on this Monday coming up?
[CUSTOMER][NEUTRAL] I in the past.
[AGENT][NEUTRAL] No, ma'am, I, I, yes, I gave you the process date, so the check was issued on [PII].
[CUSTOMER][NEUTRAL] On the [PII].
[CUSTOMER][POSITIVE] I got it, I got it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is there a reference for the call?
[AGENT][NEUTRAL] Yes ma'am, it's my name along with today's date and now that you have the call the claim number, you should be able to go to the portal and have access to that explanation of benefits as well, [PII].
[CUSTOMER][POSITIVE] OK. All right, thank you.
[AGENT][POSITIVE] All right. Well, you're welcome. So, can I help you with anything else? Oh, I hope you do too.
[CUSTOMER][POSITIVE] Have a good day.
[CUSTOMER][NEUTRAL] No, that's it. Thanks. Bye bye.
[AGENT][POSITIVE] OK, well, you're welcome.