AccountId: 011433970860
ContactId: 3a7dcdcf-c6ba-48b6-8f13-f04cd02b8754
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 728479 ms
Total Talk Time (AGENT): 217644 ms
Total Talk Time (CUSTOMER): 312918 ms
Interruptions: 4
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/3a7dcdcf-c6ba-48b6-8f13-f04cd02b8754_20250326T21:13_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling from provider office to check the claim status.
[AGENT][NEUTRAL] Sure, Ms. [PII], I can assist you.
[CUSTOMER][NEUTRAL] Could you please help me with that?
[AGENT][NEUTRAL] Yes, may I have a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] Yes, sure. It's [PII].
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] It's HCA Florida Kendal Hospital.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Member policy number is 02565852.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Member name is [PII].
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK. Thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] and have the change to [PII]. Bill amount $11,881 even.
[AGENT][NEUTRAL] OK. So [PII] $11,881 even. Is that correct?
[CUSTOMER][NEUTRAL] With
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, for future, you can check like status online through our website at [PII] and that's just optional. And bear with me just a second, let me pull the details of this ELB OK. OK, one moment.
[AGENT][NEUTRAL] All right
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK. We received the claim on [PII], process on [PII], and we're needing the explanation of benefits from the primary insurance to continue the processing of this claim.
[CUSTOMER][NEUTRAL] For the confirmation, we have already sent the primary UB to the mailing address. It's [PII]. Is this the correct address that we have previously sent to?
[AGENT][NEUTRAL] It is the correct address. Now, we have not received that.
[CUSTOMER][NEUTRAL] OK. And do you have the fax number?
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] OK, thanks for providing. This is the only primary OB. Did anything else needed with the attachment of primary OB?
[AGENT][NEUTRAL] That's all we need right now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, what's the timely filing?
[AGENT][NEUTRAL] We don't have time following limits for you to submit that information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have the claim number?
[AGENT][NEUTRAL] Yes, uh, the claim number is 3554299.
[CUSTOMER][NEUTRAL] OK. Uh, wait a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Could you please provide one more account for me?
[AGENT][NEUTRAL] Do you need to check on a claim status in a different policy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, sure. Yes. Let me just go ahead and make a note on this one. You don't need any other information on this one?
[CUSTOMER][NEUTRAL] No, nothing else.
[AGENT][NEUTRAL] OK, bear with me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] To.
[AGENT][NEUTRAL] Let me one more minute, OK?
[CUSTOMER][POSITIVE] No no worries.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, what's the next policy number?
[CUSTOMER][NEUTRAL] The next policy number is 1152749.
[CUSTOMER][POSITIVE] Wow.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Member name is [PII]
[CUSTOMER][NEUTRAL] Date of birth
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Exactly.
[AGENT][NEUTRAL] Can you verify that name one more time?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] That's not the name I got here.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] What is the date of service?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] What is the date of birth for this number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 47,000 $47,481 even.
[AGENT][NEUTRAL] How much is the total charge of the claim?
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I all.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] I have nothing for that date of service. Now, it may be because the name is not correct. So you might want to check with the provider of service on that.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] I, I'll spell it. Uh, please check it. M like Mary, E like Edward, L like Lima, E like Edward, N like Nancy, D like Delta, E like Edward, Z like Zulu. And the first name is [PII]. Is this the correct one that you have it?
[AGENT][NEUTRAL] Oh, [PII]. Yes, I do have [PII]. I didn't have the other name.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and the claim is not on file for this one.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, for the uh for the clarification, we have already submitted it on.
[CUSTOMER][NEUTRAL] [PII], uh to the mailing address [PII].
[AGENT][NEUTRAL] You said P
[CUSTOMER][NEUTRAL] Is this the correct one?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][NEUTRAL] No, you're missing the 5. It's [PII].
[CUSTOMER][NEUTRAL] OK. Is this the [PII]?
[AGENT][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Zip code is [PII]. Go ahead.
[CUSTOMER][NEUTRAL] So ID please?
[CUSTOMER][NEUTRAL] OK, OK. Continue, uh, zip code is [PII], right?
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Uh, what's the page?
[CUSTOMER][NEUTRAL] OK. Payer ID please?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] 60801. Now, this one needs to be either faxed or mail because we need the primary EOB attached to it, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Fax number, please?
[AGENT][NEUTRAL] That is [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, uh, did that affect you is [PII]?
[AGENT][NEUTRAL] Um, let me check on that.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII]. That is correct.
[CUSTOMER][NEUTRAL] OK. So, uh, could you please provide the time you're filing?
[AGENT][NEUTRAL] We don't have many following limits.
[CUSTOMER][POSITIVE] Oh good.
[CUSTOMER][NEUTRAL] OK. Uh, may I know the group ID and group name?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, the group number is 16312. Again, that's 16312.
[AGENT][NEUTRAL] The group name is Healthy Mothers, Healthy Babies.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Do you know network or your person name?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Do you know the network or person name?
[AGENT][NEUTRAL] Um, no, because we're just a secondary, there's no network with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, no worries. Your name and reference number, please?
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. Last initial [PII].
[CUSTOMER][NEUTRAL] OK. Reference number?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, no worries.
[CUSTOMER][POSITIVE] Thanks for providing the details. Have a nice day. Take care. Bye-bye for now. Nice talking to you, sir.
[AGENT][POSITIVE] You as well. Thank you for calling ATL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] No.