AccountId: 011433970860
ContactId: 06b064a2-9206-49b9-bd62-af77c1d2c6b0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249179 ms
Total Talk Time (AGENT): 113153 ms
Total Talk Time (CUSTOMER): 110564 ms
Interruptions: 2
Overall Sentiment: AGENT=1, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/06b064a2-9206-49b9-bd62-af77c1d2c6b0_20250408T15:57_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][POSITIVE] Hi, good morning. I didn't catch your name. I'm sorry.
[AGENT][NEUTRAL] My name is [PII] last initial [PII]
[CUSTOMER][POSITIVE] Thank you so much. Thank you. My name is [PII] and I'm with Boca Raton Regional Hospital. I'm following up on an, a primary EOB that we faxed in on a claim that denied for EOB.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, um, I can check and see if we received that for you, Miss [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] All right, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure. 01841148.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Sure. The name is um [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Mm perfect. Thank you.
[AGENT][NEUTRAL] All right, let me see the claims. What is the date of service for that claim?
[CUSTOMER][NEUTRAL] Sure, this is for [PII].
[CUSTOMER][NEUTRAL] To [PII]. And this is for, well, on my system.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I'm sorry. It's for a total of $69,292.89.
[AGENT][NEUTRAL] Is it?
[AGENT][NEUTRAL] Mm OK, yeah, it looks like we did because we did process so let me look into this claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I just need to let you know that for future you can check claim status online through our website at [PII] and that's just optional and let's see.
[CUSTOMER][NEUTRAL] Mm yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm still waiting on the EOB bear with me.
[CUSTOMER][POSITIVE] OK, I understand. Take your time.
[AGENT][POSITIVE] OK thank you.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Looks like we processed the claim on [PII] and the claim was denied. The reason for the denial is the outpatient benefits for the calendar year has been met.
[CUSTOMER][NEUTRAL] OK. And is there a new claim number or is it the same claim number?
[AGENT][NEUTRAL] Yes, mhm, yes, no, we have a different claim number. The new claim number is 3571283.
[CUSTOMER][NEUTRAL] 3571283
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] I'm checking to see if I can pull it up via your portal.
[AGENT][NEUTRAL] Uh, OK.
[CUSTOMER][NEUTRAL] Before I ask you for, yeah, I came up. OK, cause I needed the claim number cause I don't have the last four of the patient's social, so I couldn't pull up anything.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Oh, OK. It's fine.
[CUSTOMER][POSITIVE] Oh, nice.
[AGENT][NEUTRAL] That's what we're here for.
[CUSTOMER][NEUTRAL] It's loading. Yeah, so I don't need, but I'm waiting for it to pop up before I end the call.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Don't worry, take your time.
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][NEUTRAL] No, I don't.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I got it, so I don't need to bother you to fax me this EOB.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK. So the patient is responsible for all that the primary applied.
[AGENT][NEUTRAL] Mm, yeah, in the I can mhm.
[CUSTOMER][POSITIVE] Thank you so much. And uh call reference number if you have one, please?
[AGENT][NEUTRAL] It's my name in today's state we don't have numbers.
[CUSTOMER][POSITIVE] OK. Thank you so much, so. I appreciate it.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome. You're welcome and thank you for calling APL. You have a good day, Ms. [PII].
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye now.
[AGENT][POSITIVE] You're welcome. Bye bye.