AccountId: 011433970860
ContactId: 0ac111c8-7aa4-4f4b-a893-ba859ecee44f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 585109 ms
Total Talk Time (AGENT): 161750 ms
Total Talk Time (CUSTOMER): 128960 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/0ac111c8-7aa4-4f4b-a893-ba859ecee44f_20250516T20:59_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Um, hi, I was calling to check on the claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status. May I have your name?
[CUSTOMER][NEUTRAL] [PII], last [PII] [PII].
[AGENT][NEUTRAL] OK, and may I have a callback number just in case we get disconnected, Mr.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And that's a direct line.
[AGENT][NEUTRAL] OK, thank you. And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Tallahassee Memorial.
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] The patients what? I'm sorry.
[AGENT][NEUTRAL] Patient's policy number?
[CUSTOMER][NEUTRAL] Yes, I see.
[CUSTOMER][NEUTRAL] Patient's policy number is 60801.
[AGENT][NEUTRAL] And that's the payer ID. Do you see the number in the bottom where it says inpatient, outpatient cert? That's gonna be the number.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'm done.
[AGENT][NEUTRAL] Mm, OK. Do you have any other information that I can use to pull the member?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, yeah, I have plan calls is that.
[CUSTOMER][NEUTRAL] I can give you the date of service.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The name.
[CUSTOMER][NEUTRAL] Date of birth.
[AGENT][NEUTRAL] Do you have a social?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let me see if I can pull it up. One second, sorry.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One second please.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, let me
[CUSTOMER][NEUTRAL] Um, yes, I do have it. It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] What's the name of the patient?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Do you know if she's the main holder?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] What type of insurance is this?
[AGENT][NEUTRAL] We have many products. We have secondaries. We have hospital indemnity, cancer plans, life plans, dental plans.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, um, OK, I'll have to do a name search that so didn't pull anything, so probably she's just a dependent. Um, let me have the spelling of the last name.
[CUSTOMER][NEUTRAL] Yes, it is.
[CUSTOMER][POSITIVE] [PII]
[AGENT][POSITIVE] [PII]
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] It's, sorry, it's two names. [PII]
[AGENT][NEUTRAL] OK, I'm sorry, can you spell it out one more time?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and that's the whole last name?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And what's the first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is her date of birth?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, yeah, she's a dependent. OK.
[AGENT][NEUTRAL] All right, I found her. And you said you're looking for claim status for what date of service?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, the date of service [PII].
[AGENT][NEUTRAL] OK. How much is the total charge?
[CUSTOMER][NEUTRAL] Um, $8,711.93.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] I'm still searching.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, um, so we have no claims on file for [PII]. Um, I can go ahead and give you the correct policy number and the address where to submit the claim.
[CUSTOMER][NEUTRAL] OK, um, one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] OK, the correct policy number is 02.
[AGENT][NEUTRAL] 43
[AGENT][NEUTRAL] 10
[CUSTOMER][NEUTRAL] You said 43?
[AGENT][NEUTRAL] Yes, 43.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Um, you got the 10?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 337.
[CUSTOMER][NEUTRAL] 3
[AGENT][NEUTRAL] Do you need me to repeat it again?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] All right. And the address to submit claims is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code, let me know when you're ready for the zip code.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] OK, um, and I also had a question it said that here.
[CUSTOMER][NEUTRAL] The reason why the claim was on hold was due to like a missing EOD.
[CUSTOMER][NEUTRAL] From the primary.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Well, I don't see a claim. Do you have a claim number?
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] No, I don't. I'll go ahead and send the claim.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, yeah, we're, but yes, we're gonna need the primary EOB attached to it because this is a secondary policy, OK?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, um, may I have your name and reference number please?
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. Last initial is [PII], and we don't have reference numbers. You can use my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much, so.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good afternoon.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] You too.