AccountId: 011433970860
ContactId: 1cb8113f-9651-4d0f-8d8f-1ef91de2bfe1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 621570 ms
Total Talk Time (AGENT): 156670 ms
Total Talk Time (CUSTOMER): 223040 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/1cb8113f-9651-4d0f-8d8f-1ef91de2bfe1_20250327T14:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. Last name initial [PII]. I'm calling for a claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status, Ms. [PII]. Can you please give me your callback number just in case the call gets dropped, I'll be able to call you back.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you. And then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It is for [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] And the pay, the number is 02444692 M as in Mary, L as in Lima 7.
[AGENT][NEUTRAL] OK, let me look up that policy for us real quick.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, can you please give me the date of service?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, it was for [PII] [PII]. I'm sorry.
[AGENT][NEUTRAL] That's OK and then what is the charge amount?
[CUSTOMER][NEUTRAL] It's 1000, sorry, let me see.
[CUSTOMER][NEUTRAL] It's 175,777 with 80 cents.
[AGENT][NEUTRAL] OK, and what was the charges after the primary paid their part?
[CUSTOMER][NEUTRAL] Let me see that.
[CUSTOMER][NEUTRAL] [PII] there's no [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, I think I see it here it was.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] Go ahead and take your time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so after the primary paid it was.
[CUSTOMER][NEUTRAL] $167,796.32.
[AGENT][POSITIVE] OK, thank you so much and then can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yes, it's Florida Northwest Hospital.
[AGENT][NEUTRAL] OK, Ms. [PII], I'm gonna put you on a brief hold while I look up this claim for us and I'll be right back.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Alrighty thank you. You are on hold.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Ms. [PII], this is [PII] back with you again. So looking on data service of.
[AGENT][NEUTRAL] 8
[AGENT][NEUTRAL] [PII]. I do not find a claim on file from your facility.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Hm, OK, we actually.
[CUSTOMER][NEUTRAL] Let me see, we received a response from you guys saying that you needed the primary EOB.
[CUSTOMER][NEUTRAL] Uh, let me see if there's a claim number or something that I can.
[AGENT][NEUTRAL] Is there a claim number? Yes, that would help.
[CUSTOMER][NEUTRAL] Yeah, let me see.
[CUSTOMER][NEUTRAL] OK, yes, there's a claim number it's 3554861.
[AGENT][NEUTRAL] OK, let me see if I can find it by that claim number.
[AGENT][NEUTRAL] OK, so I've got the claim pulled up, but the date of service is uh [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And let me see what
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, the date of service from [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh yes, yes, I'm seeing it here on the claim, OK.
[AGENT][NEUTRAL] And did you send in the um the EOB?
[CUSTOMER][NEUTRAL] Yes, we, uh, have here in our notes that it was sent, uh, just wanna know if you guys received it.
[AGENT][NEUTRAL] As of right now, it's still requesting the EOB from the primary insurance.
[CUSTOMER][NEUTRAL] Mm OK.
[CUSTOMER][NEUTRAL] OK, so I guess I'll send that again can you provide me with.
[CUSTOMER][NEUTRAL] Is it [PII]?
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes ma'am, that is correct and we also have a fax number if you would like it.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Yeah, can I, can I get the fax number?
[AGENT][NEUTRAL] Yes ma'am, it's [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] You know
[AGENT][NEUTRAL] And then we also have a payer ID number if you wanted to send it electronically.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And that is 60801.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Thank you very much. um, and sorry, can you confirm what the date that it was received?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes ma'am, let me look that up real quick.
[CUSTOMER][NEUTRAL] You guys
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] We received it on [PII] and processed it on [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, but it has not been denied yet. We're just waiting for the EOB, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK awesome.
[CUSTOMER][POSITIVE] OK, so I will get that to you right away.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there any other thing that you need? Do you need a cover, uh, sheet or anything like that?
[AGENT][NEUTRAL] You can use the cover sheet and just uh put attention claims on it.
[CUSTOMER][NEUTRAL] Attention claims, OK.
[AGENT][NEUTRAL] OK, Ms. [PII], is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] That I think that would be all um do you require the EOB with the um with the, I mean the UB 04 with the primary EOB?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You can send it, any information that you can send that would help is fine.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK awesome so I think that is all. Do you have a call reference number?
[AGENT][NEUTRAL] Yes ma'am, you can use my name. It's [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you very much [PII].
[AGENT][POSITIVE] You're very welcome. I hope you have a good day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye-bye, Ms. [PII].