AccountId: 011433970860
ContactId: 2e954156-bac3-451d-8ef4-332f25678d8f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 666460 ms
Total Talk Time (AGENT): 126686 ms
Total Talk Time (CUSTOMER): 70552 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/2e954156-bac3-451d-8ef4-332f25678d8f_20250612T21:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to know the claim status.
[AGENT][NEUTRAL] Uh, can I get your name one more time, please?
[CUSTOMER][NEUTRAL] [PII], may I know your good name, please?
[AGENT][NEUTRAL] Uh, [PII], last initial [PII]
[AGENT][NEUTRAL] Can I get a good callback number in case we get disconnected, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, and the callback number is [PII] and it was a direct line.
[AGENT][NEUTRAL] I'm sorry, what was the last 4?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] Yes, and the policy number is 02424880.
[AGENT][NEUTRAL] OK give me just a moment to look that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Last name is [PII], first name is [PII], and the date of birth is [PII].
[AGENT][POSITIVE] Alright thank you so much and do you have the uh claim number or the date of service?
[CUSTOMER][NEUTRAL] Uh, no, I don't have a claim number. I have a data service.
[AGENT][NEUTRAL] OK, and what is that?
[CUSTOMER][NEUTRAL] Data services January 4th of 2024.
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] $1,691 1691.
[AGENT][NEUTRAL] Alright, give me just a moment to look that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, let me look here.
[AGENT][NEUTRAL] What is the provider's name?
[CUSTOMER][NEUTRAL] Emergency Medical Association of Tampa Bay.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, give me one moment while I look that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let me see here.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] And it was for [PII]?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Let me see here.
[AGENT][NEUTRAL] Alright, it looks like that claim was denied.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like the insured filed a claim on their behalf.
[AGENT][NEUTRAL] And the benefit has been made to the insured.
[CUSTOMER][NEUTRAL] Oh, I was denied for?
[AGENT][NEUTRAL] I'm sorry, did you ask um what the time was?
[CUSTOMER][NEUTRAL] The patient is not active for the data service.
[AGENT][NEUTRAL] Uh, yes, they were, but the patient filed a claim on their behalf and so benefits were paid to the patient instead of the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have a claim number for this one?
[AGENT][NEUTRAL] Yes ma'am, it's 34.
[AGENT][NEUTRAL] 84536.
[CUSTOMER][NEUTRAL] OK. When it was paid?
[AGENT][NEUTRAL] Let me double check here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like we would have sent.
[AGENT][NEUTRAL] Well, I don't know when it was paid to the insured, but your claim, it looks like we received the claim in [PII] and the claim was processed on [PII], um.
[AGENT][NEUTRAL] And I can't say when the insured.
[CUSTOMER][NEUTRAL] OK, could you please fax? Yes.
[AGENT][NEUTRAL] Oh, go ahead.
[CUSTOMER][NEUTRAL] Uh, could you please fax this EOB?
[AGENT][NEUTRAL] Sure, give me just one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And would the attention go to you?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's a good fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alright thank you so much, give me one moment.
[AGENT][NEUTRAL] Alright, and just to confirm I have the fax number is [PII].
[AGENT][NEUTRAL] [PII], correct?
[CUSTOMER][POSITIVE] It's correct.
[AGENT][NEUTRAL] OK, I just sent that over you can expect it within an hour.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Could you please provide the call reference number?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So we don't have call reference numbers but you can use my name and last initial in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you for assisting me. Have a great day.
[AGENT][POSITIVE] Thank you for calling [PII]. I hope you have a great day.