AccountId: 011433970860
ContactId: 16ea6ba4-e62f-4126-b508-d455b2a1cfe9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 318040 ms
Total Talk Time (AGENT): 131756 ms
Total Talk Time (CUSTOMER): 92677 ms
Interruptions: 0
Overall Sentiment: AGENT=2.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/16ea6ba4-e62f-4126-b508-d455b2a1cfe9_20250203T13:59_UTC.wav
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[AGENT][POSITIVE] Morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Last initial [PII]. I'm calling from Florida Kendal Hospital. I'm looking for a claim status.
[AGENT][NEUTRAL] [PII], it would be my pleasure to help you with that claim status this morning. What is the callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], what were the last two numbers?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] 39. Thank you, [PII]. And [PII], I can help you with claim status. What is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] 02419373.
[AGENT][NEUTRAL] Thank you, [PII] and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] The patient's full name is [PII].
[CUSTOMER][NEUTRAL] [PII], and date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And what is the date of service, please, sir?
[CUSTOMER][NEUTRAL] [PII] for the same date and bill amount is $12,614 even.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And [PII], what is the facility name?
[CUSTOMER][NEUTRAL] HCA Florida Kendal Hospital.
[AGENT][NEUTRAL] All right. Thank you, [PII]. [PII], we received that original claim.
[AGENT][NEUTRAL] Let me get that received date for you. Bear with me.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The original claim we received on [PII].
[AGENT][NEUTRAL] And processed on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] However, that claim is pending for the primary EOB.
[AGENT][NEGATIVE] Now, we received the claim again on [PII] and processed on [PII]. That was denied as a duplicate because the primary EOB was not included in the claim.
[CUSTOMER][NEUTRAL] OK. Uh, can you please uh tell me the, when the claim denied on the [PII] time?
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For duplicate, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. And
[CUSTOMER][NEUTRAL] How can we submit that uh primary or through fax or mailing address?
[AGENT][POSITIVE] You can do it through both. Actually, you can.
[AGENT][NEUTRAL] Um, facts that EOB referenced in the claim number directly to our claims department.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. May I know that fax number?
[AGENT][NEUTRAL] The fax number to our claims department is [PII].
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 942 [PII].
[CUSTOMER][NEUTRAL] OK. Can you please confirm it? [PII], right?
[AGENT][POSITIVE] That is correct. Yes, sir.
[CUSTOMER][NEUTRAL] And you need a corrected claim or um fresh claim?
[AGENT][NEUTRAL] Actually, all we need is the primary EOB showing what was applied to the deductible co-pay or co-insurance.
[AGENT][NEUTRAL] And you can fax that and just reference the policy number and the claim number and I can provide that claim number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And this is the original claim number. It is 351.
[AGENT][NEUTRAL] 0411.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. 351-041-1, right?
[AGENT][POSITIVE] Yes sir, that is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] The moment
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] My pleasure.
[CUSTOMER][NEUTRAL] And can I get a call reference number for this call?
[AGENT][POSITIVE] The call reference number is my name and today's date, and I spell my name [PII], it was a pleasure to assist you with that claim status. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Uh, no, thank you so much for your assistance.
[AGENT][POSITIVE] Thank you for calling APL Peter. You have a wonderful day.
[CUSTOMER][POSITIVE] Yes, you too. Thank you. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.