AccountId: 011433970860
ContactId: 56ee5461-5482-409e-aff1-c8a1fa2d4fb7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 842059 ms
Total Talk Time (AGENT): 148406 ms
Total Talk Time (CUSTOMER): 122324 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=-1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/56ee5461-5482-409e-aff1-c8a1fa2d4fb7_20250203T16:50_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I want to check with the claim status.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status. May I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm sorry, can you repeat that again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah. OK. Thank you. And you're calling um where are you calling from, Ms. [PII], and may I have a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, you gave me too many numbers. Can you repeat that number one more time?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And where are you calling from, Ms. [PII]?
[CUSTOMER][NEUTRAL] It does.
[CUSTOMER][NEUTRAL] Holy Cross Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] It does, um.
[CUSTOMER][NEUTRAL] 024
[CUSTOMER][NEUTRAL] 73
[CUSTOMER][NEUTRAL] 288.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] 81 20 242 [PII].
[CUSTOMER][NEUTRAL] And the amount of the claim is $2,837 even.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] Yeah, to [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's all in one claim?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, let me see if I can find the time.
[AGENT][NEUTRAL] OK, it looks like we received the claim on [PII], process [PII], and we need the explanation of benefits from the primary insurance to continue the processing of this claim.
[CUSTOMER][NEUTRAL] Can I know which insurance is primary?
[AGENT][NEUTRAL] Florida Bloom.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Florida Bloom.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Blue.
[CUSTOMER][NEUTRAL] Blue, OK.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, what, uh, claim number?
[AGENT][NEUTRAL] It is 3,504,910.
[CUSTOMER][NEUTRAL] OK. Can I get the payer ID and address of the claim which needs to be submitted to [PII]?
[AGENT][NEUTRAL] Um, I don't have that information for [PII] Blue. I can only give you our information.
[CUSTOMER][NEUTRAL] OK. Effective dates?
[AGENT][NEUTRAL] From us
[CUSTOMER][NEUTRAL] Um, like [PII] blue.
[AGENT][NEUTRAL] We don't have that information. You'll have to contact Florida Blue.
[CUSTOMER][NEUTRAL] OK, claim denied for uh uh coordination of benefits, right?
[AGENT][NEUTRAL] No, claim denied, waiting on the explanation of benefits from the primary insurance.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm, OK, can I get this, uh, you'll be via fax?
[AGENT][NEUTRAL] OK, what is the fax number?
[CUSTOMER][NEUTRAL] Um, uh, if possible, can you send, uh, the COP to the mailing address if possible?
[AGENT][NEUTRAL] Do you want us to send it to the mailing address? OK, bear with me just a second.
[AGENT][NEUTRAL] Let me see what's the address.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Still waiting on the system.
[CUSTOMER][POSITIVE] OK. Take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And that is um [PII].
[CUSTOMER][NEUTRAL] No, no, no. I'll send, send you the mailing mailing, uh.
[CUSTOMER][NEUTRAL] Name.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I will send you the mailing address or name.
[AGENT][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] No, no, no, we cannot send it to any other person unless it's the same one in the EOB so either we can fax it to you or either we can send it by mail, but it's gonna go to the address on the explanation of benefits. We cannot change that.
[CUSTOMER][NEUTRAL] Can you
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK. Can you fax that to you? I'll tell you the fax number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that's [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] To what attention?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for Miss [PII]. Yeah, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And uh can I get the call reference and your name?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. My name is [PII], that's [PII]. Last initial is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day, Mr. [PII].
[CUSTOMER][NEUTRAL] Same to you. Bye.
[AGENT][POSITIVE] Thank you, bye bye.