AccountId: 011433970860
ContactId: 1fc6f0f5-d8b5-47cd-a095-f97758bb9d77
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 355480 ms
Total Talk Time (AGENT): 144722 ms
Total Talk Time (CUSTOMER): 109267 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/1fc6f0f5-d8b5-47cd-a095-f97758bb9d77_20250520T13:40_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, good morning. My name is [PII]. I am calling from a provider's office to follow up on a claim, please.
[AGENT][NEUTRAL] Sure, I can assist you with claims, Ms. [PII], and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility for my note?
[CUSTOMER][NEUTRAL] It's Baptist Health Medical group physicians.
[AGENT][NEUTRAL] All right, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02138751
[CUSTOMER][NEUTRAL] The letter M as in Mary, L as in Lima number 7.
[AGENT][NEUTRAL] OK, perfect. Thank you. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] OK perfect thank you.
[AGENT][NEUTRAL] OK, and what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah, the date of service was [PII], and the total bill amount was $456.
[AGENT][NEUTRAL] OK, let me see if I can find this claim. And for future, you can check claim status online through our website at [PII] and that's just optional.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You said it was [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Was it a hospital charges or procedures?
[CUSTOMER][NEUTRAL] This was for hospital charge and uh the procedure code was 99223.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me try this one. Let me see if this is in.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] I'm waiting on the system for the documents.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Mm, let me try one more.
[AGENT][NEUTRAL] Is it one single um procedure code or is it several procedure codes?
[CUSTOMER][NEUTRAL] One single for code, yes.
[AGENT][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, let me pull this other two please.
[AGENT][NEUTRAL] I have several, but I don't see that one. yeah, added.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It doesn't look like we have received that claim so.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] This is a claim that was electronically submitted.
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] No, tell me, was the patient eligible on that date of service?
[AGENT][NEUTRAL] Yes, um, let me give you the effective date. Mhm. Let's see. We have an effective date of [PII] and it's still active.
[CUSTOMER][POSITIVE] I like to spend.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. OK, um, what is your timely filing?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] We don't have timely filing limits.
[CUSTOMER][NEUTRAL] Oh good. OK. All right. Now, can this claim be um fax just to expedite the process?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, you can send it by fax. Um, the fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And this is one of our secondary policies, so we need the primary explanation of benefits attached to the claim, OK?
[CUSTOMER][POSITIVE] Yes, I have that ready. Yes, OK, thank you so much. Can I have a reference number please?
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, that is [PII]. May I have the spelling of your name, Miss?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. All right, is there anything else I may help you with today, Miss [PII]?
[CUSTOMER][NEUTRAL] Yeah, let me just reconfirm that fax number. It's [PII].
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] Oh. Thanks again, [PII]. I appreciate your help. Thank you very much.
[AGENT][POSITIVE] You're welcome. You're welcome and thank you for calling APO have a good day.
[CUSTOMER][NEUTRAL] You too. Goodbye.