AccountId: 011433970860
ContactId: fff5aa14-c904-4f19-84de-72404b4f019e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202210 ms
Total Talk Time (AGENT): 86277 ms
Total Talk Time (CUSTOMER): 56447 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/fff5aa14-c904-4f19-84de-72404b4f019e_20250529T15:53_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] Hey [PII], this is [PII] with South Miami Hospital. Need some help with the claim? Need to see if you got this claim on this patient.
[AGENT][NEUTRAL] Hey
[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 and the policy number?
[CUSTOMER][NEUTRAL] [PII] and the policy is 02553885.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Excuse me.
[CUSTOMER][POSITIVE] Thank you, dear.
[AGENT][NEUTRAL] You're welcome. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], oh wow. Gonna Wolf, [PII], date of birth.
[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 and the total bill for the claim?
[CUSTOMER][NEUTRAL] [PII] and it was 42,687.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me see if this is yours. We only have, we've only received one claim for the member, um, but it's in processing. So let me see if I can uh pull the documents to see if this is your date. Hold on one second.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you. I appreciate it.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] 425.
[AGENT][NEUTRAL] OK. And um,
[AGENT][NEUTRAL] This looks to be your claim. Um, it does have the same date of service. What was the name of the provider?
[AGENT][NEUTRAL] South Miami.
[CUSTOMER][NEUTRAL] South Miami Hospital. Mhm.
[AGENT][NEUTRAL] OK, yeah, um, so this does have the same data service and
[AGENT][NEUTRAL] I do see the claim form here and then the explanation of benefits. So, I'm from Aetna, so this is for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Yup. All right. What's the claim number?
[AGENT][NEUTRAL] It's in processing. It hasn't been processed yet, so it's just all zeros until it's, it's completed. We just got it on the [PII] of this month, Tuesday.
[CUSTOMER][NEUTRAL] Hold on one second.
[CUSTOMER][POSITIVE] I done 527. All right, dear. Thank you very, very much. I appreciate all your help.
[AGENT][POSITIVE] You're very welcome. Was there any
[CUSTOMER][NEUTRAL] We shall talk soon.
[AGENT][POSITIVE] Alrighty, well, thank you so much for.
[CUSTOMER][NEUTRAL] No, that's
[AGENT][POSITIVE] OK, well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You too have a good weekend coming up here.
[AGENT][POSITIVE] Thank you, [PII], you also. Bye-bye.
[CUSTOMER][POSITIVE] Mm thanks, bye.