AccountId: 011433970860
ContactId: 32b90240-0ac2-4451-84e7-e4baa21f0458
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 341369 ms
Total Talk Time (AGENT): 121860 ms
Total Talk Time (CUSTOMER): 79425 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/26/32b90240-0ac2-4451-84e7-e4baa21f0458_20250626T14:18_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Could you help me with the claim status?
[AGENT][POSITIVE] OK I'll be more than happy to help you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Just one
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the member's policy number?
[CUSTOMER][NEUTRAL] 02478746 M M as in Mike, L as in Lexington, and the numeric 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] The first name is [PII]. It's [PII] and the last name is [PII] R.
[AGENT][NEUTRAL] Thank you and the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. May I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the bill amount is $14,046.00.
[AGENT][NEUTRAL] Thank you. And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] H C Florida University Hospital.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Alright, so the claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 359.
[AGENT][NEUTRAL] 884 8.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[CUSTOMER][NEUTRAL] Uh, may I know the reason for the design?
[AGENT][NEUTRAL] We were
[AGENT][NEUTRAL] We were unable to accept assignments of benefits for the claim filed due to a discrepancy reported by the IRS.
[AGENT][NEUTRAL] That is a combination of the name and tax ID number on the account.
[CUSTOMER][NEUTRAL] So, what documents needed? Any documents needed or what will be the next step taken?
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] So you'll have to visit the IRS website for additional information and to correct whatever errors are with your provider name and tax ID.
[CUSTOMER][NEUTRAL] So we need to visit IRS website.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, do we get all the information in the IRS website?
[AGENT][NEUTRAL] Yes, on how to resolve the issue, yes, you'll get that from the IRS website.
[CUSTOMER][NEUTRAL] 1 2nd.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, can I get the, yes, uh link website to the name.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So, I would assume it's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, can you tell me the process how to get the status and all the details if you don't mind.
[AGENT][NEGATIVE] There is no other status. Because of that, we were unable to process the claim to the provider.
[AGENT][NEUTRAL] And benefits were provided to the insured.
[CUSTOMER][NEUTRAL] So what will be done in the IRS website? We need to send in the correct claim.
[AGENT][NEUTRAL] No, on the IRS website, you're you're trying to correct whatever issues are with the company name and the tax ID number on your account.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So that can be done in the website. Can you guide me?
[AGENT][NEUTRAL] I am unsure. I uh we don't, uh.
[AGENT][NEUTRAL] Because I don't work with the IRS, so I'm not sure how their website works.
[AGENT][NEUTRAL] But as a company, you need to
[CUSTOMER][NEUTRAL] OK, thank you. And can I get the call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date, and that's [PII], first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] No, nothing else. Thanks for asking.
[AGENT][POSITIVE] Thanks for calling APL [PII]. Have a good day. Bye-bye.