AccountId: 011433970860
ContactId: 5758e06a-1ccf-4c39-9e7e-51dddbd02efa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 276950 ms
Total Talk Time (AGENT): 113193 ms
Total Talk Time (CUSTOMER): 98533 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/5758e06a-1ccf-4c39-9e7e-51dddbd02efa_20250609T17:26_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] Hi, [PII]. Good afternoon. My name is [PII] and I'm with Boca Raton Regional Hospital. Claim status, please.
[AGENT][NEUTRAL] Hi
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claim status. And may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] Thank you. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] 11.
[AGENT][NEUTRAL] All right, and the member's policy number?
[CUSTOMER][NEUTRAL] Sure, that is um
[CUSTOMER][NEUTRAL] 02270277 ML 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] I wish your portal would allow us to pull up the claim without the last four of the social.
[CUSTOMER][NEUTRAL] If we don't have the claim number.
[AGENT][NEUTRAL] Oh, yeah. Does it ask for the account number?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, I have all that except the last 4, and if I don't have that, then the next option is to search my claim number which I don't have.
[AGENT][NEGATIVE] Oh, then none of it works.
[AGENT][NEUTRAL] Oh, OK, I got it. Um, and
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I have him here. I just need you to verify the member's first and last name and date of birth.
[CUSTOMER][NEUTRAL] Furest number is [PII] and his date of birth is
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] Sure. [PII]. And we bill for a total of $11,671.74.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And again, just for the call, the information provided is a verification of benefits, not a guarantee of payment. So I am showing that the claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 360.
[AGENT][NEUTRAL] 4115.
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] On May, what day?
[AGENT][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Thank you. Can you check for the attachment cause we did um bill with the primary EOB and can you give me that claim number again, please?
[AGENT][NEUTRAL] 360.
[AGENT][NEUTRAL] 4115.
[CUSTOMER][NEUTRAL] OK, I'm on your.
[AGENT][NEUTRAL] Alright, hold on one moment.
[CUSTOMER][NEUTRAL] Portal, let me see if I can find it.
[AGENT][NEUTRAL] Um, so for this one it's just one page that came over and it looks like it's, hold on one second, I'm waiting for it to load. It's just the claim form.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So I'll need the claim form. Thanks for checking. Uh, what's the fax number to send you the primary EOB?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Any any attention line?
[AGENT][NEUTRAL] Um, attention APL claims department.
[CUSTOMER][POSITIVE] Thank you. And the mailing address, please.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][POSITIVE] Thank you. Any timely filing?
[AGENT][NEUTRAL] Um, there's no timely filing as long as the policy is active on the data service, you can submit the claim at any time.
[CUSTOMER][POSITIVE] All righty. Thank you. And a call reference number, please.
[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].
[CUSTOMER][POSITIVE] All righty. Thank you, [PII]. That's gonna be all.
[AGENT][POSITIVE] You're welcome and thanks for calling APL [PII]. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.