AccountId: 011433970860
ContactId: 24b2ac36-761d-45c1-87f8-7da56c95a6b7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 594549 ms
Total Talk Time (AGENT): 178455 ms
Total Talk Time (CUSTOMER): 191241 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/24b2ac36-761d-45c1-87f8-7da56c95a6b7_20250116T22:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I'm calling on behalf of provider's office to check on a claim status.
[AGENT][NEUTRAL] OK [PII], I can help you with claim status can you please give me your call back number?
[CUSTOMER][NEUTRAL] Yes, sure. The callback number is [PII].
[AGENT][NEUTRAL] Thank you. And then what's the patient's name?
[CUSTOMER][NEUTRAL] The patient name is.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yes. The patient name is [PII].
[AGENT][NEUTRAL] OK, and then what is the patient's date of birth?
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][NEUTRAL] [PII] and what was the year again, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's policy number?
[CUSTOMER][NEUTRAL] The patient policy number is 02496785.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let me look that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then what is the date of service?
[CUSTOMER][NEUTRAL] The date of service is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] The total bill amount is $7,979.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, and then what is the charge after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Please give me a moment.
[CUSTOMER][NEUTRAL] Please give me a moment.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's 3:50.
[AGENT][NEUTRAL] $350?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you and then what is the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] It's HCA Florida Kendal Hospital.
[AGENT][NEUTRAL] Thank you and then I'm going to uh pull in this claim for I put you on hold while I do that and I'll be right back.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], I found the claim. The claim number is 3532541.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim was received on [PII] and was processed on [PII].
[AGENT][NEUTRAL] And the claim was denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] OK. OK, let me verify the claim number. It's 3532541, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. And it's denied for primary use, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, one month, but we have actually sat.
[CUSTOMER][NEUTRAL] I mean, we have send the primary will be through the mailing address. Uh, the mailing address is [PII]. OK. And the ZIP code is [PII]. Could you please check whether you have received the primary?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, that is the correct address. And if, when did you send it?
[CUSTOMER][NEUTRAL] We have ended on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How has ended on [PII].
[AGENT][NEUTRAL] OK, it's not showing up yet. So it doesn't look like that we have it as of now.
[AGENT][NEUTRAL] Now that could mean that it's being.
[CUSTOMER][NEUTRAL] OK, so you have not received the primary.
[AGENT][POSITIVE] Well, the thing is, is, is it's been so soon, it's, it may be in progress too.
[AGENT][NEUTRAL] So once we receive it, it takes 7 to 10 business days.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. 7 to 10 business days, right? OK. um.
[AGENT][NEUTRAL] Yes, yes, once.
[CUSTOMER][NEUTRAL] OK, so, uh, may I know which option we can consider, like, uh, do we send again or do we call back after, uh, some time?
[AGENT][NEUTRAL] Yes, I would allow it a little more time and call back and then if we don't have it then I would send it again.
[AGENT][NEUTRAL] And let me give you the fax number we also have a.
[CUSTOMER][NEUTRAL] OK, so we can call back after.
[AGENT][NEUTRAL] Yes, we also have a fax number if you want that um you can send claims through the fax too.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Also have a payer ID number if you wanna send electronically.
[CUSTOMER][NEUTRAL] And so we
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Would you like the payer ID number?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Before that, do we need to send the primary UB alone or you need to send the UB along with the UB 044?
[AGENT][NEUTRAL] No, you can send it in reference to claim number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And um
[CUSTOMER][NEUTRAL] Could you please provide the copy of the new bill?
[AGENT][NEUTRAL] Can I please provide what, ma'am?
[CUSTOMER][NEUTRAL] Copy of an EOB for this. You said it has been denied as primary be needed, right? So I just, uh, I'm requesting the EOB for your insurance.
[AGENT][NEUTRAL] Yes, we don't have the EOB. That's why it's been denied. We need the EOB from the primary insurance. We are not the primary insurance.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so could you please confirm whether uh we should call back or we can send the primary.
[AGENT][NEUTRAL] Yes, you need to send the primary EOB.
[CUSTOMER][NEUTRAL] facts.
[CUSTOMER][NEUTRAL] OK, through fax, right?
[AGENT][NEUTRAL] You could send it by fax, you can send it electronically or you can mail it in.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, thank you for that. So we will send the primary bit through fax. Is there any attention?
[AGENT][NEUTRAL] Claims you can put attention claims and reference the claim number 3532541.
[CUSTOMER][NEUTRAL] OK. And um is there any time limit?
[AGENT][NEGATIVE] No, we don't have a timely filing limit.
[CUSTOMER][NEUTRAL] OK. Could you please provide the call reference number for this one?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name. It's [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you, [PII]. Thank you for your assistance. Have a great day.
[AGENT][POSITIVE] You too, Ms. [PII], thank you for calling APL you have a blessed one bye bye.