AccountId: 011433970860
ContactId: 40a268e3-3bea-46e4-803f-f5f63bc8ebd3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316540 ms
Total Talk Time (AGENT): 124839 ms
Total Talk Time (CUSTOMER): 110740 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/40a268e3-3bea-46e4-803f-f5f63bc8ebd3_20250221T21:55_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling on behalf of provider office to check the claim status.
[AGENT][POSITIVE] Well, [PII], it would be my pleasure to assist you with claim status. What is the callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII] and the policy number for the patient?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Policy number is?
[CUSTOMER][NEUTRAL] 10654532. M as in Mary, L as in Lima, H as in Henry.
[AGENT][NEUTRAL] 10654532
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That is too many numbers. What is the patient's last name?
[CUSTOMER][NEUTRAL] Last name is [PII].
[AGENT][NEUTRAL] And the first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Can you spell the first name?
[CUSTOMER][NEUTRAL] First name is [PII].
[AGENT][NEUTRAL] And do you have the patient's social? And last name is [PII]?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes. The social is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright thank you I did find the policy there was just one extra number in it.
[AGENT][POSITIVE] And it would be my pleasure to assist you with that claim status. What is the data service?
[CUSTOMER][NEUTRAL] 7 2020 24. For that, the bill amount is
[CUSTOMER][NEUTRAL] $55,398.68.
[AGENT][NEUTRAL] What's the name of the facility please, ma'am?
[CUSTOMER][NEUTRAL] HCA Florida West Side Hospital.
[AGENT][NEUTRAL] And what is the total bill amount again?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] $5454,9398.68.
[AGENT][NEUTRAL] OK, thank you. I did find that claim, [PII], it was processed under another policy number the.
[AGENT][NEUTRAL] The correct policy number is 181, I'm sorry, 185.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] 1211. That was the most recent policy that the patient had.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] And we placed the claim on that policy. We received the claim on
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 12 3 24 and processed on 12 6 24.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And that claim was denied because the services were rendered after the policy termed.
[AGENT][NEUTRAL] [PII]'s policy turned on [PII].
[CUSTOMER][NEUTRAL] Effected date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Term date?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And I can provide that claim number if you'd like as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Claim number is 353.
[CUSTOMER][NEUTRAL] Hi
[AGENT][NEUTRAL] 7980.
[CUSTOMER][NEUTRAL] OK, so member, so you should have to send the letter to member to go to.
[CUSTOMER][NEUTRAL] To maintain the policy activity, is that right?
[AGENT][NEUTRAL] Or to find out if they have an active policy.
[CUSTOMER][NEUTRAL] OK. Is the member having any other uh insurance?
[AGENT][NEUTRAL] Not with APL.
[CUSTOMER][NEUTRAL] OK. The reference number, please.
[AGENT][NEUTRAL] The reference number is my name and today's date.
[AGENT][NEUTRAL] I spell my name [PII].
[CUSTOMER][POSITIVE] OK. Thanks for providing the details. Have a nice day. Take care. Bye-bye for now. Nice talking to you.
[AGENT][POSITIVE] And it's been a pleasure to assist you with that claim status. Thank you for calling APL. I hope you have a wonderful weekend.
[CUSTOMER][NEUTRAL] Same to you. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] I