AccountId: 011433970860
ContactId: 4c6cff57-6dbf-4b55-bbbe-267e091ed84b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 393339 ms
Total Talk Time (AGENT): 113984 ms
Total Talk Time (CUSTOMER): 144530 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/4c6cff57-6dbf-4b55-bbbe-267e091ed84b_20250226T18:44_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, there. This is [PII] calling from provider's office to check on claim status. Could you please help me with this?
[AGENT][NEUTRAL] Yeah, I could check on a claim for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes. Before that, can you please spell your name?
[AGENT][NEUTRAL] Sure, it's [PII]
[CUSTOMER][NEUTRAL] Initial to your name?
[AGENT][NEUTRAL] A
[CUSTOMER][POSITIVE] Thank you very much. Can you please provide me more for claim status on this call?
[AGENT][NEUTRAL] Yeah, I can check that claim for you. Um, what was that policy number, please?
[CUSTOMER][NEUTRAL] Yeah, 01866994, M as in Mike, L as in Lima, H.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] OK. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Name of the patient, it is [PII], and the date of birth it is uh [PII] sorry, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Got it thank you verifying that [PII]. Uh, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] The date of visit is [PII].
[AGENT][NEUTRAL] OK, and then the uh billed amount, please?
[CUSTOMER][NEUTRAL] The bill amount is $17,909 even.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Uh, I'm sorry, uh, what was the name of the provider's office this was with?
[CUSTOMER][NEUTRAL] HCA Florida Northwest Hospital.
[AGENT][POSITIVE] OK, thank you for verifying that.
[AGENT][NEUTRAL] OK, so we did receive this claim, uh, looks like we're missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] OK. Uh, can you please provide me the received date of the claim?
[AGENT][NEUTRAL] Yes, one moment.
[CUSTOMER][NEUTRAL] Can you please tell me a little slow so that I will be not down here?
[AGENT][NEUTRAL] Sure, so we received this claim [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, and uh
[AGENT][NEUTRAL] And it was
[AGENT][NEUTRAL] Processed
[CUSTOMER][NEUTRAL] Process done?
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII]. And the claim number, please?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, that is 3,503,950.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] Yes, that's the claim number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And uh the claim is denied due to missing uh primary explanation of benefits, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] Can you please provide me uh the uh uh primary payer name?
[AGENT][NEUTRAL] Um, I don't have that information as this is their secondary medical policy.
[CUSTOMER][NEUTRAL] OK. Can you please uh provide me the fax number so that uh we will be fax it to you.
[AGENT][NEUTRAL] Yes, that is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 9423. Yeah. Can you please wait for one minute?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] OK. Thank you.
[CUSTOMER][NEGATIVE] Still don't need to send.
[CUSTOMER][NEUTRAL] Can you please provide me call reference number for this call?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. And my last initial is [PII] Was there anything else I could help you with [PII]?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, thank you. But uh can you please provide me more for claims on this call?
[AGENT][NEUTRAL] Oh we were needing to check additional claims?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, uh, were they for different members?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, yes, one moment, I'll let you know when I'm ready for that next policy number um and the uh reference number would be the same for all of them.
[CUSTOMER][POSITIVE] OK, thank you very much.
[CUSTOMER][NEUTRAL] Yeah, I'm moving to the another one. Can you please wait?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Sure, I'm ready when you are.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Yeah, actually, I have checked from my side, uh, but there is no other claims to take the claim status. This is the last one.
[AGENT][NEUTRAL] OK, we just have one more?
[CUSTOMER][NEGATIVE] No, no, I'm not getting the uh more claims uh from my side. This is the last claim.
[AGENT][NEUTRAL] OK, uh, so there wasn't anything else I could help you with?
[CUSTOMER][POSITIVE] No, that's all the information. Thank you very much, [PII], for helping.
[AGENT][POSITIVE] OK, of course, thanks for calling APL. Yeah, have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye.