AccountId: 011433970860
ContactId: 561e147a-24ab-4e31-8e36-8b7d0b775bbc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 477410 ms
Total Talk Time (AGENT): 174456 ms
Total Talk Time (CUSTOMER): 123096 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/561e147a-24ab-4e31-8e36-8b7d0b775bbc_20250331T13:04_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling AP.
[AGENT][NEUTRAL] Yeah, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII].
[CUSTOMER][NEUTRAL] to check on a claim status.
[AGENT][NEUTRAL] Hello. Is there anyone there?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Uh, can you hear
[CUSTOMER][NEUTRAL] Can you hear me? Hello?
[AGENT][NEGATIVE] Bare, uh, barely. I can hear you better now.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] OK, ma'am. Hi, this is [PII] calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing to check claim status on one claim, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Uh yeah, the callback number is [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] Yeah, the member's policy number will be
[CUSTOMER][NEUTRAL] 02467155 M as in Mike, L as in Lima, and the number 8.
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you need any information that I do provide for you today?
[CUSTOMER][NEUTRAL] No, only I just want to go, want to.
[AGENT][NEUTRAL] There will be a verification to your payment.
[AGENT][NEUTRAL] Yes, ma'am. I understood.
[CUSTOMER][NEUTRAL] 12
[CUSTOMER][NEUTRAL] Yeah, I just want to know the claim status for this.
[AGENT][NEUTRAL] Yes, and again, any information provided will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh yeah, the patient's name will be uh [PII] This will be the first name.
[CUSTOMER][NEUTRAL] And the last name will be [PII]
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount for her, please?
[CUSTOMER][NEUTRAL] Yeah, the date of service will be [PII] and the bill amount will be.
[CUSTOMER][NEUTRAL] $174,210 and even.
[AGENT][NEUTRAL] 14, I'm sorry, 1742.
[AGENT][NEUTRAL] One, is that correct?
[CUSTOMER][NEUTRAL] Yeah, 1742102.
[CUSTOMER][NEUTRAL] $174,210 and even.
[AGENT][NEUTRAL] OK, are you
[AGENT][NEUTRAL] Hm, OK, so $17,421. Is that correct?
[AGENT][NEUTRAL] Or are you saying $174,210?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, $174 210 cents.
[AGENT][NEUTRAL] OK, so that's OK.
[AGENT][NEUTRAL] Is it
[AGENT][NEUTRAL] 172, excuse me, 14,210.
[CUSTOMER][NEUTRAL] 174,210.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And again, you said date of service is [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, now for [PII], we do not have a claim on file for that bill's amount.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] You don't have any claim on file?
[AGENT][NEUTRAL] Not for data. Give me just a moment.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] What is the facility name for the claim?
[CUSTOMER][NEUTRAL] HCA Florida University Hospital.
[AGENT][NEUTRAL] Now we show this is a data service of 731 to 81 for that billed amount.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, then there is no claim on file.
[CUSTOMER][NEUTRAL] Um, OK. May I have the, uh, payer name?
[CUSTOMER][NEUTRAL] A payer ID?
[AGENT][NEUTRAL] The payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And when the claim is submitted to APL June?
[CUSTOMER][NEUTRAL] We have
[CUSTOMER][NEUTRAL] Uh, yeah.
[AGENT][NEUTRAL] OK, when you submit the claim, you will also need to send a copy of the primary insurance company's explanation of benefits as well. We will also have to have that for claim review.
[CUSTOMER][NEUTRAL] Uh, it does mean.
[CUSTOMER][NEUTRAL] OK, no problem. Then may I have your, OK. May I have your mailing address or the fax number?
[AGENT][NEUTRAL] The claim fax number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Attention claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I have your name and the call reference number?
[AGENT][NEUTRAL] Again my name is [PII]. Along with today's date will be your call reference number.
[AGENT][NEUTRAL] And then lastly [PII] once we have processed the claim here at APL we do have a portal in which you can check claim status.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] By going to [PII].
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thanks for that.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Is there anything else, [PII] that I can help you with?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] Thanks for that and uh have a good day. Bye-bye.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, thank you then if that's all I can help you with for calling APL and I hope you have a nice day as well.
[CUSTOMER][NEUTRAL] Mhm.