AccountId: 011433970860
ContactId: 26b7b802-8b50-40e0-aef3-37f0cd039d12
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305779 ms
Total Talk Time (AGENT): 99130 ms
Total Talk Time (CUSTOMER): 95994 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/26b7b802-8b50-40e0-aef3-37f0cd039d12_20250605T20:36_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Good afternoon. This is [PII] with uh Boca Raton Regional Hospital. I'm following up on a claim we faxed in the primary EOB.
[CUSTOMER][NEUTRAL] And a claim.
[AGENT][NEUTRAL] OK. Well, I can definitely help you with the claim status and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure, that is um
[CUSTOMER][NEUTRAL] Let me pull that up for you. That is 226-547-8.
[AGENT][POSITIVE] Take your time.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure, this number is um [PII], and her date of birth is, let me pull that up for you.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the um data of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] Uh, [PII] $1660.
[CUSTOMER][NEUTRAL] Uh, this claim had processed without the primary EOB and I had called on it and I was told the primary EOB was not attached, so we faxed it on the EOB on [PII]. I have a fax number, if you'd like.
[AGENT][NEUTRAL] No, I'm OK, and all the information provided is a verification of benefits, not a guarantee of payment. Let me see. And what's the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure, Boca Raton Regional Hospital.
[AGENT][NEUTRAL] All right. And do you mind if I place you on just a brief hold while I locate the claim?
[CUSTOMER][NEUTRAL] I don't mind at all. Go ahead.
[AGENT][NEUTRAL] All right, hold on one moment.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] I don't know, I haven't received it yet.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes, [PII], I'm here.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. So no, I'm not showing that it's been received. Um, how did you said you faxed it?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Back in April, and what fax number did you fax it to?
[CUSTOMER][NEUTRAL] I think I see what's wrong. I see [PII] in the [PII], but there's a digit off here short of one digit.
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] OK. So that's the correct fa. Thank you. Is there a timely filing?
[AGENT][NEUTRAL] No, ma'am, no timely filing, um, as long as the policy was active on the data service, you can file at any time and let me just make sure to be on the safe side. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This policy has been active since [PII], so yes, it was active on the data service.
[CUSTOMER][NEUTRAL] The, OK, the current?
[AGENT][NEUTRAL] Yes, it's currently active.
[CUSTOMER][NEUTRAL] OK, thank you. And the call reference number if you have one, please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. Again, the first initial of my last name is [PII].
[CUSTOMER][POSITIVE] Alrighty, I think I spoke to you earlier today.
[AGENT][NEUTRAL] I think so too, but I'm not, if it wasn't today, I I remember speaking with you, yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][POSITIVE] It's a pleasure. All righty. Thank you so much, [PII]. I appreciate it.
[AGENT][POSITIVE] Well, thank you. It's a pleasure speaking with you as well. You're welcome. Thanks for calling APL. Have a great evening.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.