AccountId: 011433970860
ContactId: 3487d819-f460-444c-8746-332f929c54e3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 245720 ms
Total Talk Time (AGENT): 80654 ms
Total Talk Time (CUSTOMER): 133987 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/3487d819-f460-444c-8746-332f929c54e3_20250324T17:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII], uh, calling from Boca Regional, um, following up on the secondary billing of, of claim for one of our patients.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um, first, could I get a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Um, 678-4208.
[CUSTOMER][NEUTRAL] 8800.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Do you have the member's social?
[CUSTOMER][NEUTRAL] Oh, I'm sorry, wrong one. Sorry, sorry, sorry. I was looking at the wrong one. It's, uh, sorry, [PII].
[AGENT][NEUTRAL] OK. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] uh [PII] [PII]. Date of birth?
[AGENT][NEUTRAL] OK. Thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah it's a secondary billing.
[CUSTOMER][NEUTRAL] But uh
[CUSTOMER][NEUTRAL] Can you spell your, your first name for me, please?
[AGENT][NEUTRAL] OK, I'm not
[AGENT][NEUTRAL] Yes, ma'am. It's [PII], um, it's spelled [PII]
[AGENT][NEUTRAL] And my last initial is [PII].
[CUSTOMER][NEUTRAL] Oh easy, OK.
[CUSTOMER][NEUTRAL] [PII], OK, thank you EV OK.
[AGENT][NEUTRAL] Mhm. And yes, ma'am, and let's see. I'm not showing a claim with that date of service, those dates of services on file. Um, how was the claim submitted?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 97
[CUSTOMER][NEUTRAL] It was mailed uh let me check the.
[CUSTOMER][NEUTRAL] Oh, let me check the dates again.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], sorry.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. No, ma'am. I'm
[CUSTOMER][NEUTRAL] And it was actually.
[CUSTOMER][NEUTRAL] Uh, claim address fax number. I'm not sure if it was faxed or mailed, but the.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Address we have is the [PII].
[AGENT][NEUTRAL] Yes, ma'am. That's the correct mailing address and claims can also be faxed in and we have a pair ID.
[CUSTOMER][NEUTRAL] Yeah, I have the PRID. I'm sorry, the, uh, fax number [PII].
[AGENT][NEUTRAL] Yes, ma'am, and please attention it to the claims department.
[CUSTOMER][NEUTRAL] Yeah, that well we sent that out we sent it out on um.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, let me look again. You said [PII]?
[AGENT][NEUTRAL] For [PII]
[CUSTOMER][NEUTRAL] [PII] yeah.
[CUSTOMER][NEUTRAL] Yeah, through [PII], yes.
[AGENT][NEUTRAL] Yes, ma'am. I'm not showing that claim on file. I apologize. Um, when was it submitted?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Oh wow. Yeah, it would definitely be in our system by now.
[CUSTOMER][NEGATIVE] And it was hard. It was mailed hard copy. Uh, yeah, it was followed up with 30 day no claim on file, uh, submitted via hard copy. Follow up 10 days claim like. OK, no cover patient total allowance. I don't know what that is.
[CUSTOMER][NEUTRAL] Is that the patient responsibility? OK, that's the primary secondary.
[CUSTOMER][NEUTRAL] Yeah, so
[CUSTOMER][NEUTRAL] Um, I'll fax it over, but.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, there's no timely filing limit, so it can be resubmitted. Just be sure if you fax it to attention to the claims department.
[CUSTOMER][NEUTRAL] I'm pretty sure
[CUSTOMER][POSITIVE] Yes, correct. Mhm.
[CUSTOMER][POSITIVE] OK great alright and I'll fax it over today thank you.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] Mm, no, ma'am thank you you have a great day.
[AGENT][POSITIVE] OK. You do the same, [PII]. Thank you for calling ATL. Mm bye.
[CUSTOMER][NEUTRAL] Alright bye.