AccountId: 011433970860
ContactId: 580586fd-4eb6-42ae-8a21-b003f41a7dde
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 265820 ms
Total Talk Time (AGENT): 120133 ms
Total Talk Time (CUSTOMER): 81317 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/2025/03/20/580586fd-4eb6-42ae-8a21-b003f41a7dde_20250320T21:03_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, [PII]. My first name is [PII], my last name is [PII] calling you from the provider's office looking for claim status.
[AGENT][POSITIVE] Well, [PII], it would be a pleasure to assist you with that claim status. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh just hold up.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh, yes, the patient side yes.
[CUSTOMER][NEUTRAL] 02331433.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient's first name is [PII] and the last name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you, and it would be my pleasure to assist you with that claim status. Do you have the claim number or data service?
[CUSTOMER][NEUTRAL] Net of services 528-2024 total charges.
[CUSTOMER][NEUTRAL] $1,787 even.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] I'm checking on that claim for you. What is the facility name, please?
[CUSTOMER][NEUTRAL] Uh, yes, this is calling from Saint Mary Hospital.
[AGENT][NEUTRAL] Is that Bonsecu Saint Mary's Hospital?
[CUSTOMER][NEUTRAL] Mhm, yes.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And [PII], I'm checking on that claim for you. It looks like it's been submitted several times. Looks like we did rec and it was requesting the primary EOB. We did receive that EOB on 3-10-25.
[AGENT][NEUTRAL] And processed on [PII].
[AGENT][NEUTRAL] And we're requesting a more detailed EOB from the primary. What we need, [PII], is an EOB that shows what was applied to the deductible, co-pay, or co-insurance after the primary processed.
[CUSTOMER][NEUTRAL] I just.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK, so, uh, what is the fax number?
[AGENT][NEUTRAL] The fax number to our claims department is [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[AGENT][NEUTRAL] And if you have that detailed explanation of benefits, you can just fax that regarding the reference for referencing the policy number and claim number.
[CUSTOMER][NEUTRAL] OK, uh, what is the claim number?
[AGENT][NEUTRAL] The claim number is 357.
[AGENT][NEUTRAL] 476 7.
[CUSTOMER][NEUTRAL] And do you have any call reference number?
[AGENT][NEUTRAL] It's going to be my name in today's date, and I spell my name, [PII]
[AGENT][NEUTRAL] First initial, last name, [PII], sorry.
[CUSTOMER][NEUTRAL] OK. And uh
[CUSTOMER][NEUTRAL] Got you. So, uh, is it the claim was denied on [PII]?
[AGENT][NEUTRAL] The original claim, let me check that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, the original claim was denied on [PII], requesting the primary EOB.
[CUSTOMER][NEUTRAL] Uh, any time we funding limit to submit the primary UOB.
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] Fuck
[CUSTOMER][POSITIVE] OK, thank you so much. That's all I need for today and have a very blessed day ahead.
[AGENT][POSITIVE] Well, [PII], it's been a pleasure to assist you with that claim status. Thank you for calling APL and I hope you have a wonderful afternoon.
[CUSTOMER][POSITIVE] Thank you. Bye.
[AGENT][POSITIVE] Thank you. Bye-bye.