AccountId: 011433970860
ContactId: 1347c5b5-0f9a-4d53-854a-f77b736b7741
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 498619 ms
Total Talk Time (AGENT): 151535 ms
Total Talk Time (CUSTOMER): 217945 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/1347c5b5-0f9a-4d53-854a-f77b736b7741_20250102T13:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII] calling on behalf of provider's office.
[CUSTOMER][NEUTRAL] To check on claim status.
[AGENT][NEUTRAL] Can I help you, [PII], what's the policy number?
[CUSTOMER][NEUTRAL] Yes, uh, just a moment, uh.
[CUSTOMER][NEUTRAL] Can I know your name?
[AGENT][NEUTRAL] [PII] A, first initial last name is [PII]
[AGENT][NEUTRAL] And the policy number please.
[CUSTOMER][NEUTRAL] Yes, the policy number is 02504909M.
[CUSTOMER][NEUTRAL] L. 8.
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] And callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, [PII], actually, we have sent, yeah, actually, we have sent in a primary UB.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Through fax
[AGENT][NEUTRAL] OK, can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes. The patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, and you're calling on a claim status for what date?
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII].
[AGENT][NEUTRAL] And the amount?
[CUSTOMER][NEUTRAL] $5,276 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Is this the facility ER visit?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes. Yeah.
[AGENT][NEUTRAL] Or the, or the physician's fee.
[CUSTOMER][NEUTRAL] Yeah, it is a facility HCA Florida Merki Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Alright, so I do show that that claim was reprocessed on [PII], issuing a payment of $2450.
[AGENT][NEUTRAL] Under claim number.
[AGENT][NEUTRAL] 354.
[AGENT][NEUTRAL] 549 7.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. It's 354-549-7, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. The claim was reprocessed on [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And the
[CUSTOMER][NEUTRAL] OK. And can I know the amount?
[AGENT][NEUTRAL] $2450.
[CUSTOMER][NEUTRAL] OK. $50 even, right?
[AGENT][NEUTRAL] OK, what, what amount do you have?
[CUSTOMER][NEUTRAL] Yeah, it's $2450 even, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] Yeah, can I know the, uh, can I know the data, how much time it will take to pay, to make the payment?
[AGENT][NEUTRAL] OK, the payment was was processed on the [PII]. Um, it's usually released the next business day, of course, so that would have been the [PII] was Friday.
[AGENT][NEUTRAL] So it would have released on this on Monday following the [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK. And the paid amount was $2450 right?
[AGENT][NEUTRAL] Again, that is correct. And you can also check your status on our online service center on at [PII].
[CUSTOMER][NEUTRAL] OK. And also
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you have another question?
[CUSTOMER][NEUTRAL] Yes. And can I know the allowed amount?
[AGENT][NEUTRAL] That that information is on the uh primary ELB that you submitted.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can I know the mode of the payment and also
[AGENT][NEUTRAL] It's an individual check.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The check number?
[AGENT][NEUTRAL] It's 202.
[AGENT][NEUTRAL] 0360.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And also, can you verify the
[CUSTOMER][NEUTRAL] Pay to address
[AGENT][NEUTRAL] It's the address that's on your claim. You wanna verify that?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is your billing address?
[CUSTOMER][NEUTRAL] Yes, our billing address, yeah, our pay address is [PII].
[AGENT][NEUTRAL] OK, that is the address that the check was mailed to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. It was the correct address, right?
[AGENT][NEUTRAL] That's the address that the check was mailed to, the one that you just verified.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] Um, yeah, and also, can I know the check amount?
[CUSTOMER][NEUTRAL] It was single amount, right? Single, single check, right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] Yeah, and also, can I have the claim received date and the uh process date again?
[AGENT][NEUTRAL] Receive date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I've given you the process date, the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And also, can I have the check issue date?
[AGENT][NEUTRAL] [PII], sir.
[CUSTOMER][NEUTRAL] OK. Same, right.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][POSITIVE] Yeah, give me [PII].
[CUSTOMER][NEUTRAL] Could you, do you have the check reserve, or?
[CUSTOMER][NEUTRAL] Can you finally check?
[CUSTOMER][NEUTRAL] Whether it was reached or received or not by us.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Can you please uh
[CUSTOMER][NEUTRAL] Trace the check. Do you have the check traer?
[AGENT][NEUTRAL] OK, now we just issued the check, sir, on the [PII], just allow time to receive it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, can I know the that?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Can I know the time, uh, that how many days it will take?
[AGENT][NEUTRAL] How many days does it take to
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] To receive the check.
[AGENT][NEUTRAL] We can't verify that. Once it's released from our office, it's up to the mailing system.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Anything else?
[CUSTOMER][NEUTRAL] OK. Yes, yes, uh.
[CUSTOMER][NEUTRAL] OK, we, we'll call back you on uh next business days or next Monday.
[CUSTOMER][NEUTRAL] Within 4 days, right?
[AGENT][POSITIVE] You can call back at any time.
[CUSTOMER][NEUTRAL] Is it
[AGENT][NEUTRAL] But we won't be able to reissue the check until after 30 days from [PII], so basically just allow time to receive the check. It was just released.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much. Can I have the, yeah, can I have the call reference number, please?
[AGENT][NEUTRAL] This past Monday.
[AGENT][NEUTRAL] My name and today's date, first initial of my last name is [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And, and there is no member responsibility, right?
[AGENT][NEUTRAL] We do not determine patients responsibility.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you. Yeah, thank you so much. Thanks for your assistance. Have a great day and happy New Year.
[AGENT][POSITIVE] You're welcome, [PII]. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah, yeah, bye bye.
[AGENT][NEUTRAL] Uh-huh.