AccountId: 011433970860
ContactId: 1f30259a-7066-4def-813e-600d6a08ad31
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 838799 ms
Total Talk Time (AGENT): 249223 ms
Total Talk Time (CUSTOMER): 192521 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/1f30259a-7066-4def-813e-600d6a08ad31_20250522T21:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Um, I'm calling from Florida Hospital Medical Group. I'm trying to get information for a quite a few claims for a patient.
[AGENT][NEUTRAL] OK, do you have the, can I get your name or I'm sorry, what did you say [PII], is that right?
[CUSTOMER][NEUTRAL] Yeah, [PII]
[AGENT][POSITIVE] OK, you have a good callback number, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And that is a direct line.
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number for the patient?
[CUSTOMER][NEUTRAL] I do, that is 02451577 ML 8.
[AGENT][NEUTRAL] OK, and the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, and you're needing claim status or what information?
[CUSTOMER][NEUTRAL] Yes, I, uh, claim status, we, um, sent the claims to a primary payer Blue Cross Blue Shield, and we haven't received any information from the secondary payer on file which is APL.
[AGENT][NEUTRAL] OK, do you have the first day of service?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] Uh, build them out.
[CUSTOMER][NEUTRAL] $361 with $176.67 remaining.
[AGENT][NEUTRAL] OK, looks like.
[AGENT][NEUTRAL] Uh, we received the claim 4:15, process [PII].
[AGENT][NEUTRAL] Yeah, we made a payment of 16 or 17667.
[CUSTOMER][NEUTRAL] 14:17.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And has the payment been sent or is it still pending?
[AGENT][NEUTRAL] Uh, yes, we sent it, um.
[AGENT][NEUTRAL] The signal check. Let me see if the, it's cleared.
[AGENT][NEUTRAL] Uh it was sent to [PII].
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] The the right address?
[CUSTOMER][NEGATIVE] That is not correct.
[CUSTOMER][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] Sorry, um.
[CUSTOMER][NEUTRAL] Do we need to send in a correct uh updated W9 form or can I just give you the address?
[AGENT][NEUTRAL] And let me pull the claim if it's if we pay to the claim address on the claim, you'll have to submit a corrected claim.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just one moment.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Uh, yes, that was the address on the claim.
[AGENT][NEUTRAL] So we'd need a corrected claim.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And what was that address one more time? I'm sorry.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And that zip code one more time.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] I'm sorry, my keyboard's been sticking.
[AGENT][NEUTRAL] Oh, you're fine. No worries. Uh, [PII].
[CUSTOMER][NEUTRAL] Uh, just one more second.
[CUSTOMER][NEUTRAL] OK, uh,
[CUSTOMER][NEUTRAL] And were these crossed over from um the primary payer or did.
[CUSTOMER][NEUTRAL] He received the claim from us. I don't know if you can tell and.
[CUSTOMER][NEUTRAL] And I can't tell whether or not the primaries crossed it over.
[AGENT][NEUTRAL] I can't tell. I just have the
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I have the HIPA 1500 or the CMS 1500 and then the primary EOB but I can't tell how it was.
[AGENT][NEUTRAL] Submitted
[CUSTOMER][POSITIVE] All righty.
[CUSTOMER][NEUTRAL] Um, I have 2.
[CUSTOMER][NEUTRAL] 6 others, uh.
[CUSTOMER][NEUTRAL] I don't know if that's gonna be the same situation with all of them though.
[AGENT][NEUTRAL] Um, is it the same patient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Uh, let's see.
[AGENT][NEUTRAL] Uh, what's that next data service?
[CUSTOMER][NEUTRAL] $220 of 2025 for $25.
[AGENT][NEUTRAL] 35
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, looks like we received it 4:15, paid on [PII].
[AGENT][NEUTRAL] Let me see the check number page 1661, a single check.
[AGENT][NEUTRAL] 497
[AGENT][NEUTRAL] Yeah, same thing, um, sent to that same address.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, do you have the next date?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That would be um
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] For $361.
[AGENT][NEUTRAL] $361 is that what you said?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Uh, what was the leftover or after primary pay? Can you?
[CUSTOMER][NEUTRAL] $176.67.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's see. Received 4:15, paid for 17, 176 67.
[AGENT][NEUTRAL] And
[AGENT][NEGATIVE] Oh, you said 3:31, right? it's not the right one.
[CUSTOMER][NEGATIVE] Yes, or 361, sorry, day service is 331. 0 my gosh, it's late.
[AGENT][NEUTRAL] I know, yeah.
[AGENT][NEUTRAL] Let's see, 331, 2025. OK.
[AGENT][NEUTRAL] There we go.
[AGENT][NEUTRAL] That is.
[AGENT][NEUTRAL] OK, that one received 4:15, paid for 17, and that was check 203-9500.
[AGENT][NEUTRAL] Let me look that up
[AGENT][NEUTRAL] Uh, same thing there, um, same address.
[AGENT][NEUTRAL] And what's that next date?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] That is [PII].
[CUSTOMER][NEUTRAL] For $535.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yeah, I'm here.
[CUSTOMER][NEGATIVE] OK, sorry, my phone drops calls constantly. I had a panic moment.
[AGENT][NEUTRAL] OK, that was 34.
[AGENT][NEUTRAL] You said 5:35, is that right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, that 123.
[AGENT][NEUTRAL] That one we received 4:15, process 417.
[AGENT][NEGATIVE] This one was actually denied as
[AGENT][NEUTRAL] Office visits are not covered under the policy.
[AGENT][NEUTRAL] And then the other charge was not covered when performed in doctor's office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Well, at least I can do something with that one.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, next day of service is $225.25 dollars for $33.
[CUSTOMER][NEUTRAL] This one was also built in the office.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] You said 225, 25, is that right?
[AGENT][NEUTRAL] Let's shoot.
[CUSTOMER][POSITIVE] Thank you, I'm sorry.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, let's see this one.
[AGENT][NEUTRAL] OK, receive 4:15, process 4:17, and
[AGENT][NEGATIVE] Service not covered when performed in doctor's office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 331 2025 for 480.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, what was the leftover charge?
[CUSTOMER][NEUTRAL] That would be $150.53.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] OK, 3592.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, received the 4:15, process 417.
[AGENT][NEUTRAL] Paid 150 53 and that was to the [PII] address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the last one is for 41 of 25.
[CUSTOMER][NEUTRAL] For $346.
[AGENT][NEUTRAL] OK, 41, sorry.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm that one let's see 359.
[AGENT][NEUTRAL] OK, that one received 425, paid 428.
[AGENT][NEUTRAL] 125 29. Let me check that address.
[AGENT][NEUTRAL] Uh, same thing, [PII].
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] And you said it's [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. [PII]
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, thank you so much for all of your help. um, can I get a call reference number please?
[AGENT][NEUTRAL] Uh, reference is my name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][POSITIVE] All right. Thank you again for your help and I hope you have a great rest of your day.
[AGENT][POSITIVE] Thanks for calling APL. You as well bye bye.