AccountId: 011433970860
ContactId: 35381a47-9fd3-456a-92f3-832c1ca3453b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 457359 ms
Total Talk Time (AGENT): 200457 ms
Total Talk Time (CUSTOMER): 140827 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/35381a47-9fd3-456a-92f3-832c1ca3453b_20250127T18:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII]. My name is spelled as [PII], and my last name [PII] is. I'm calling from the provider's office to check on the claim status.
[AGENT][NEUTRAL] OK, yeah, I could check a claim for you. Uh, [PII], can I get a good call back number from me first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] I'm sorry, that was, was that, yes, please.
[CUSTOMER][NEUTRAL] I can repeat it for you. It's.
[CUSTOMER][NEUTRAL] OK. [PII]. It's a direct line, there's no extension.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, I do. It's 0157.
[CUSTOMER][NEUTRAL] 123 M as in Mike. L as in Lima 7.
[AGENT][NEUTRAL] All right, let's see that was 0157123 ML 8, right?
[CUSTOMER][NEUTRAL] 7. It's end with 7.
[AGENT][NEUTRAL] ML 7. OK, so I think we are missing a digit um before the M there should be another digit there [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] The swim league.
[CUSTOMER][NEUTRAL] Let me verify. It's 0157123 ML 7. Is that right?
[AGENT][NEUTRAL] Right, that's what I got, um, but there is supposed to be another digit before that um, um, do you maybe have their social? I could search for them that way.
[CUSTOMER][NEUTRAL] Right, but.
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, what, what was the last digit?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you. One moment please.
[AGENT][NEUTRAL] What was the name of the patient?
[CUSTOMER][NEUTRAL] Patient's first name is [PII]. Patient's last name is [PII].
[CUSTOMER][NEUTRAL] The patient's date of birth is [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So I think you were missing a digit from that policy number that you gave me. Uh, however, that one is not currently active. I do have that updated policy number if you'd like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Please, that will be. What's the updated for.
[AGENT][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] Yes, this policy number is 0240.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 8806.
[AGENT][NEUTRAL] And it is, uh, effective date was [PII] and it is currently active.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Of course. Alrighty, and what was the date of service for this claim, [PII]?
[CUSTOMER][NEUTRAL] D of source is [PII].
[AGENT][NEUTRAL] OK, so I did need that older policy. Oops, hold on, sorry about that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] Alright, one moment, what was the bill amount, [PII]?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] To
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me check a few seconds. Thank you. I found it. Total charge amount is $33,467 even.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK. One moment, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Please take your time.
[AGENT][POSITIVE] Appreciate it.
[AGENT][NEUTRAL] And this was, uh, is it Florida Medical Center?
[CUSTOMER][NEUTRAL] And it
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I did find this claim, bear with me just a moment.
[AGENT][NEUTRAL] OK, so we need a more detailed copy of the explanation of benefits from their primary insurance. We did receive uh a primary EOB, but it did not list the amounts that were applied to uh deductible, co-pay or co-insurance, so we do need that information. Um, once we have that we can continue getting this processed.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Thank you. What's the timely filing limit to submit the details?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] There is no timely filing limit.
[AGENT][NEUTRAL] And let me give you this policy number [PII]. I'm sorry for the confusion, um but uh this one's that was active during this time, it was uh 01.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] 57
[AGENT][NEUTRAL] 0123.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And then I've got that claim number as well.
[CUSTOMER][NEUTRAL] What's the claim number?
[AGENT][NEUTRAL] It is 33.
[AGENT][NEUTRAL] 63201.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] May I get your name?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] How can I submit the details?
[CUSTOMER][NEUTRAL] Is there any mailing address?
[AGENT][NEUTRAL] Yes, I've got a mailing address and I've got a fax number as well. um I can give you that mailing address first let me know when you're ready.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, it is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yes, and then did you want that fax number as well?
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] OK, the fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yeah, was there anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] This is all the things I need to know. Thank you for asking. May I get the call reference number?
[AGENT][NEUTRAL] A reference number would just be my first name, last initial, and today's date. Uh, so my last initial is A as in alpha.
[CUSTOMER][NEUTRAL] At
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Yeah, of course, thanks for giving us a call, [PII]. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you for the assistance.
[CUSTOMER][POSITIVE] You too. Have a great day.
[AGENT][POSITIVE] Thank you bye bye.