AccountId: 011433970860
ContactId: 2386d90c-1f98-4f87-85dd-f7e63330f07a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 863200 ms
Total Talk Time (AGENT): 263941 ms
Total Talk Time (CUSTOMER): 256397 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/2386d90c-1f98-4f87-85dd-f7e63330f07a_20250131T14:01_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office to check on your client status. How are you doing today?
[AGENT][POSITIVE] I'm doing well, [PII]. Thank you for asking. How are you today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, I'm great.
[AGENT][NEUTRAL] Good, [PII]. What is a good callback number, please?
[CUSTOMER][POSITIVE] Good.
[CUSTOMER][POSITIVE] Yeah, sure. My callback number is [PII]. It's a direct call, no extension needed.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] The policy number is 02413429 M as in Marco L as in Lima 7.
[AGENT][NEUTRAL] Thank you, [PII] and the patient's name and date of birth, please, sir?
[CUSTOMER][NEUTRAL] The patient's name is
[CUSTOMER][NEUTRAL] I that's.
[CUSTOMER][NEUTRAL] [PII]. And the date of birth is [PII].
[AGENT][POSITIVE] Alright thank you and [PII], it would be a pleasure to assist you with that claim status. What is the data service?
[CUSTOMER][NEUTRAL] The date of service is [PII]. And the total charge is
[CUSTOMER][NEUTRAL] $7,838 even.
[AGENT][NEUTRAL] Thank you. And what is the facility name please, [PII]?
[CUSTOMER][NEUTRAL] The facility name is FitF Florida Palms West Hospital.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And I can help you with that claim status. [PII], I'm showing that we did receive that claim on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] This claim is pending for the primary EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Thanks for that. Uh, could you please tell me your name?
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And [PII], did you need that claim number?
[CUSTOMER][POSITIVE] Thanks for the.
[CUSTOMER][NEUTRAL] Yeah, please.
[AGENT][NEUTRAL] The claim number is 353.
[AGENT][NEUTRAL] 4046.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, could you please, uh, send me fax number attention?
[AGENT][NEUTRAL] Um, the our ELBs are.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You want the fax number to send in the primary EOB?
[CUSTOMER][NEUTRAL] Yeah yes.
[AGENT][NEUTRAL] OK, I'm sorry, you can send that to our claims department at [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 3659423
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, could you please tell me the payer ID?
[AGENT][NEUTRAL] Payer ID is 60801.
[CUSTOMER][NEUTRAL] Could you please tell me the mailing address?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] [PII] City, [PII], and the zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the zip code is [PII]. Am I right?
[AGENT][POSITIVE] Yes sir, that's correct.
[CUSTOMER][NEUTRAL] Uh, thanks for that. Could you please tell me the effective date?
[AGENT][NEUTRAL] Effective date on the policy is [PII], and the policy is active.
[CUSTOMER][NEUTRAL] Uh, could you please tell me the time refunding limit?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Could you please tell me the group name or group number?
[AGENT][NEUTRAL] Yes, sir, the group name is
[AGENT][NEUTRAL] Ferretti Group of America and that's F E R R E T T I Ferretti Group of America.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That's F E R R I E N T. Am I right?
[AGENT][NEUTRAL] F E R R E T T I.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Fainty Group of America, am I right?
[AGENT][NEUTRAL] That's correct. And the group number?
[AGENT][NEUTRAL] Is 19145.
[CUSTOMER][NEUTRAL] OK, thanks for. Could you please uh give me the call reference number?
[AGENT][NEUTRAL] Code reference number is my name and today's date.
[CUSTOMER][NEUTRAL] Could you please help me with the other claim, if possible?
[AGENT][NEUTRAL] Sure. Is it for the same patient or different patient?
[CUSTOMER][NEUTRAL] Uh, no, for the different page cabinet, I'll try to pull a client before the.
[AGENT][POSITIVE] Alright, I am ready for that next policy number whenever you are, [PII].
[CUSTOMER][NEUTRAL] Oh sure.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, thanks for your patience. Uh, shall we start with the second claim?
[AGENT][NEUTRAL] I'm ready for the policy number.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, thank you for that. The policy number is 020.
[CUSTOMER][NEUTRAL] 889-985.
[AGENT][NEUTRAL] Thank you, [PII]. And what is that patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient's name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][POSITIVE] Let me get all that pulled up and I'll be happy to help you with that claim status.
[AGENT][NEUTRAL] Alright, now then, what is that data service?
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII].
[AGENT][NEUTRAL] And that build amount.
[CUSTOMER][NEUTRAL] That's 40 a minute. I will notify it.
[CUSTOMER][NEUTRAL] Yeah, that's $45,269 even.
[AGENT][NEUTRAL] And what is that facility name please, sir?
[CUSTOMER][NEUTRAL] The facility name is HCA Florida Kindle Hop.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] You know and I'm showing that we have requested the primary EOB. We did receive that primary ELB on uh actually today.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I apologize, actually on the [PII], and it is in line for processing.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Looks like being reviewed today.
[CUSTOMER][NEUTRAL] Can I know what's the normal process?
[CUSTOMER][NEUTRAL] You know normal processing tech.
[AGENT][NEUTRAL] Uh, 7 to 10 business days, but it looks like this claim is processing today.
[AGENT][NEUTRAL] It looks like they're reviewing it now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it should be completed.
[AGENT][NEUTRAL] Soon.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, but the normal processing days is 7 business days, am I right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Is the call reference number the same or different?
[AGENT][NEUTRAL] It's the same.
[CUSTOMER][NEUTRAL] For this way.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, could you please help me with the claim if possible?
[AGENT][NEUTRAL] I can.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Yeah, thanks for that a minute.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Thanks for your patience. Can I start with this one.
[AGENT][NEUTRAL] I'm sorry, what?
[CUSTOMER][NEUTRAL] Uh, the policy number is
[CUSTOMER][NEUTRAL] 02035270
[CUSTOMER][NEUTRAL] M as in Marco, L as in Lima, and the number 8.
[AGENT][NEUTRAL] All right, thank you. And that name and date of birth?
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you, and that date of service, please, sir?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the total bill amount is $2,29. 86 cents.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the facility name?
[CUSTOMER][NEUTRAL] The facility name is Park Ridge East Hospital.
[AGENT][NEUTRAL] Is that Park Ridge Medical Center?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, Park Ridge East Hospital.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] I'm checking, bear with me just one second.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] It looks like we've received it several times. So bear with me just a second.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Looks like we have received that several times.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We're still, it's still pending for the primary EOB.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So
[AGENT][NEGATIVE] It looks like we've received the claim several times, but not the primary EOB. Now this claim,
[AGENT][NEUTRAL] The last claim we received on.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 115 and processed on [PII], still pending for the primary EOB.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Could you please repeat me the process date? That's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, the other details are the same which you have given before, am I right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Uh, could you please, uh, help me with the effective date?
[AGENT][NEUTRAL] Effective date on the policy is [PII] and current.
[CUSTOMER][NEUTRAL] Could you please tell me the plan type?
[AGENT][NEUTRAL] Secondary gap policy.
[CUSTOMER][NEUTRAL] Yeah that's
[CUSTOMER][NEUTRAL] OK, thanks for that. Uh, and the call reference number is the same, am I right?
[AGENT][NEUTRAL] It is the same, yes, sir.
[CUSTOMER][POSITIVE] OK, thanks for this [PII]. Thanks for your assistance. Have a great day.
[AGENT][POSITIVE] Been a pleasure to assist you with that claim status, [PII]. Also just for future reference, we do have a provider portal at [PII] where you have 24/7 access to EOBs, claim status and claim submission. But thank you for calling APL and I hope you have a wonderful day, [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] Thank you. Hi.
[AGENT][NEUTRAL] Bye bye.