AccountId: 011433970860
ContactId: f6c64877-d2ff-4670-8a25-e819f49f0ddc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 216990 ms
Total Talk Time (AGENT): 91722 ms
Total Talk Time (CUSTOMER): 63920 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/f6c64877-d2ff-4670-8a25-e819f49f0ddc_20250403T18:16_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII] and this will be.
[CUSTOMER][NEUTRAL] Initial D like [PII]. I'm calling for claim status, please.
[AGENT][NEUTRAL] OK. Well, I can definitely help you with the claim status and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK, my number is [PII] is a direct line.
[AGENT][NEUTRAL] Thank you. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] OK, 02126470 Mary Lima 7.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim and the total bills?
[CUSTOMER][NEUTRAL] [PII], just one day of service for $19,568.13.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And what is the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] HCA Florida Northside Hospital.
[AGENT][NEUTRAL] Here we go.
[AGENT][NEUTRAL] Alright, so I'm showing the claim was received on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That claim number is 357-467-6.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[AGENT][NEUTRAL] As the services were rendered after coverage was terminated.
[AGENT][NEUTRAL] And this policy was active, hold on one moment, from [PII].
[CUSTOMER][NEUTRAL] OK, so it was, it started when?
[AGENT][NEUTRAL] Um, hold on, let me
[AGENT][NEUTRAL] It was effective from [PII].
[AGENT][NEUTRAL] To [PII].
[CUSTOMER][NEUTRAL] So [PII], and he was seen on [PII], so they won't cover it at all?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right, the services, the policy wasn't active on the data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So then it's patient responsibility, correct?
[AGENT][NEUTRAL] So we don't determine patient responsibility because we're not the major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get a reference number for this call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. And again, that's [PII] my [PII].
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][POSITIVE] Thank you so much thank you for your help bye bye.
[AGENT][NEUTRAL] You're welcome, [PII]. Is there anything else I can help with?
[CUSTOMER][NEGATIVE] Mm no thank you.
[AGENT][POSITIVE] Alright, thanks for calling APO bye bye.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Bye