AccountId: 011433970860
ContactId: 4850b3a8-5388-4a94-8185-e6f6825ec853
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 395140 ms
Total Talk Time (AGENT): 162335 ms
Total Talk Time (CUSTOMER): 121065 ms
Interruptions: 2
Overall Sentiment: AGENT=1.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/4850b3a8-5388-4a94-8185-e6f6825ec853_20250528T12:47_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][POSITIVE] Hi, [PII]. This is [PII] from provider office.
[AGENT][POSITIVE] Good morning [PII], how are you doing today?
[CUSTOMER][POSITIVE] Yeah, nice. How are you?
[AGENT][POSITIVE] I'm doing good, and how may I assist you today?
[CUSTOMER][NEUTRAL] Yeah, I need a uh claim status for a client.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] 1
[AGENT][NEUTRAL] OK, may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 02467155 M as in Mike, L as in Lima.
[CUSTOMER][NEUTRAL] 8. Can I get your name?
[AGENT][NEUTRAL] Yes, again, my name is [PII].
[CUSTOMER][POSITIVE] Yeah, thank you.
[AGENT][NEUTRAL] You're welcome. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah. The patient name is uh B and Evelyn, and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII], with the total bill charge of $174,210 even.
[AGENT][NEUTRAL] Wait a minute. Can you say those numbers again? 1700.
[CUSTOMER][NEUTRAL] 4
[CUSTOMER][NEUTRAL] And $210.
[AGENT][NEUTRAL] Can you just give the numbers again, just give them all together.
[CUSTOMER][NEUTRAL] It's $174,210.
[AGENT][NEUTRAL] $1,742 and what's this, there's too many numbers, or is it 17,000?
[CUSTOMER][NEUTRAL] Then
[CUSTOMER][NEUTRAL] Yeah, it's 17,400 and
[CUSTOMER][NEUTRAL] 42
[AGENT][NEUTRAL] Say the numbers again. Just, just all together.
[CUSTOMER][NEUTRAL] It's 1
[CUSTOMER][NEUTRAL] It's $1,740,210 even.
[AGENT][NEUTRAL] Please just, can you just say the numbers all together, just the numbers, no dollars, just the numbers.
[CUSTOMER][NEUTRAL] It's 174,210.
[AGENT][NEUTRAL] 0.00.
[CUSTOMER][NEUTRAL] Yeah, right.
[AGENT][NEUTRAL] OK, so that's $174,210. OK. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] It's uh Haya Florida University Hospital.
[AGENT][NEUTRAL] OK, I believe I just found it. Hold on one moment. OK, here it is.
[AGENT][NEUTRAL] Alright, I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 360.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 5635.
[AGENT][NEUTRAL] And the claim just finished processing?
[AGENT][NEUTRAL] Looks like today, either yesterday.
[CUSTOMER][NEUTRAL] OK. So it is uh
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Sorry, uh, you can
[AGENT][NEUTRAL] May I continue?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so the claim was either um it's a generic date on there, so it looks like it just finished processing um either last night or this morning. So the check and all of that information will be generated, um, I would say to give us a call back maybe tomorrow, but there is a payment of $400 that's being made to the provider.
[CUSTOMER][NEUTRAL] $400.
[AGENT][NEUTRAL] Yes, $400.
[CUSTOMER][NEUTRAL] OK. Uh, and
[CUSTOMER][NEUTRAL] Uh, it is, uh, not either paid, right? Only the payment is generated, right?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, there is no payment is made, right?
[AGENT][NEUTRAL] There's a payment of $400 that is being sent to you, but the claim just finished processing, so I don't have like the check number or anything that should be available tomorrow. The $400.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get the normal processing time?
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Go ahead, I'm sorry, I was just trying to give you the information. What did you say?
[CUSTOMER][NEUTRAL] Can I get the normal processing uh period for claims?
[AGENT][NEUTRAL] Like the turnaround?
[CUSTOMER][NEUTRAL] Uh, yeah, the processing period.
[AGENT][NEUTRAL] It's 7 to 10 business days.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] And can I get the process date of this?
[CUSTOMER][NEUTRAL] Yeah. So, can I get the process date as well?
[AGENT][NEUTRAL] Again, the claim just finished processing either yesterday or today, so it shows as [PII]. So again, you'll have to give us a call back tomorrow once that information generates, so we can give you the process date and the check number and all of that, but because it just finished, it's not ready yet.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK. Thank you, [PII], for assisting me today. Uh, can I get the call reference number for this call?
[AGENT][NEUTRAL] So there's no call reference number?
[CUSTOMER][NEUTRAL] Before that, can I check the
[CUSTOMER][NEUTRAL] Yeah. And the claim number is 3605635, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK. So, thank you, [PII], for assisting me today. Have a great day. Bye for now.
[AGENT][POSITIVE] You also, thanks for calling. Yeah, bye bye.