AccountId: 011433970860
ContactId: 4a647379-b685-4bd0-b5f2-390c26611864
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 424880 ms
Total Talk Time (AGENT): 156998 ms
Total Talk Time (CUSTOMER): 78163 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/4a647379-b685-4bd0-b5f2-390c26611864_20250424T18:49_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] Hello, this is [PII] calling from HCA Florida West Side Hospital to check on claim status.
[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 and the policy number?
[CUSTOMER][NEUTRAL] Uh yes, my number is [PII] to direct line.
[CUSTOMER][NEUTRAL] The policy number is 02462632ML8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Do you have any other first name for the member?
[CUSTOMER][NEUTRAL] Uh, let me take a look. Hold on one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, all right. Thank you so much for verifying 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 bill for the claim?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] $207,301.22.
[AGENT][NEUTRAL] And it was January, so it should have been this one. And that was 207,000. Can you repeat the rest, please?
[CUSTOMER][NEUTRAL] $301.
[CUSTOMER][NEUTRAL] And 22 cents.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So the policy that was active at that time was 2586053, and I'm pulling that up now to see if there's a claim on file.
[AGENT][NEUTRAL] This is all one claim, hold on one moment.
[AGENT][NEUTRAL] And [PII], do you mind if I place you on just a brief hold while I go through these claims?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 805.
[AGENT][NEUTRAL] What?
[AGENT][NEUTRAL] Just to be on the safe side.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, 505.
[AGENT][NEUTRAL] 330, 0, they're going to miss 330.
[AGENT][NEUTRAL] 356-6830 OK.
[AGENT][NEUTRAL] And then 329.
[AGENT][NEUTRAL] And then 654. OK, so let's try this one. I think that was the only one I was missing maybe.
[AGENT][NEUTRAL] A dollar. OK, we don't have any claims from HCA though. And were any of those HCA? OK.
[AGENT][NEUTRAL] OK, hello [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. So, we received um 4 claims for the data service and I went through them all, but they're not from your provider or the, or nowhere near the total bills. Um, however, there is no timely filing, so if you did want to file, you still could.
[CUSTOMER][NEUTRAL] I think there was, it was gonna be a paper claim.
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes, that's the correct address.
[CUSTOMER][NEUTRAL] Is there an option to fax it?
[AGENT][NEUTRAL] Yes, you can fax it or we have an electronic payer ID as well. Um, our fax number is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Alright, and then, uh, once it's received, what's the time frame for processing?
[AGENT][NEUTRAL] Um, just in general, it's 7 to 15 business days, but um,
[AGENT][NEUTRAL] Well, hold on, this one isn't. So we say 7 to 10 business days if it's canceled 7 to 15 because it could be delayed, um, but business days.
[CUSTOMER][NEUTRAL] And what is the payer ID?
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][NEUTRAL] And then you said that it was active under 2586053. Is that is that the policy number cause I have a totally different policy number.
[AGENT][NEUTRAL] Right, that's the policy number that was active on the data service.
[CUSTOMER][NEUTRAL] OK, so again that's 258-6053?
[AGENT][POSITIVE] Mhm, that's correct.
[CUSTOMER][NEUTRAL] Alright, well I think that's all I needed then um besides just a reference number for the call.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII], and again, my first name is [PII]
[CUSTOMER][POSITIVE] Alright, thank you for your help. Have a nice day.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help with?
[CUSTOMER][NEUTRAL] Uh, no, that's all, thanks.
[AGENT][POSITIVE] Alright, thanks for calling APO bye bye.
[CUSTOMER][NEUTRAL] Goodbye.