AccountId: 011433970860
ContactId: 5cb5509c-519e-4e85-a240-44f4f958b26b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 409100 ms
Total Talk Time (AGENT): 165637 ms
Total Talk Time (CUSTOMER): 134780 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/5cb5509c-519e-4e85-a240-44f4f958b26b_20250620T19:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is. How can I help you?
[CUSTOMER][NEUTRAL] I didn't catch your name. I'm sorry, good afternoon.
[AGENT][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] with uh Boca Raton Regional Hospital. I'm calling for claim status.
[AGENT][NEUTRAL] OK, yeah, I can, uh, check on a claim for you.
[CUSTOMER][NEUTRAL] And do you spell your name with a [PII] or [PII] [PII]?
[AGENT][NEUTRAL] It's [PII] I'm sorry, would you mind spelling your name for me as well?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't mind. It's [PII] There's some like static on the line, I'm breaking the conversation, so I'm sorry if I'm talking over you.
[AGENT][NEUTRAL] Oh,
[AGENT][POSITIVE] Uh oh, no, no, you're fine um and I can definitely check on that claim. Can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you and do you have that policy number?
[CUSTOMER][POSITIVE] Yes, I do. It is um.
[CUSTOMER][NEUTRAL] 02236420 ML 8.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Sure, we have this member as [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Got it thank you for that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Uh, [PII] for $384.
[AGENT][NEUTRAL] OK, that was [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I did find this claim. It looks like we're missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] OK. What's the, what's your claim number to receive date and the process date, please?
[AGENT][NEUTRAL] Sure, that claim number is 3561447.
[CUSTOMER][NEUTRAL] 3561447
[AGENT][NEUTRAL] Correct, uh, this claim was received [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[CUSTOMER][POSITIVE] Thank you so much. Can you check for the United Healthcare EOB that we attached to the claim?
[AGENT][NEGATIVE] No, we have not received an EOB with this.
[CUSTOMER][NEUTRAL] Yeah, that's how it denied, but can you search for it, please?
[CUSTOMER][NEUTRAL] Can you check the image and tell me how many pages were received?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Of what was received in
[AGENT][NEUTRAL] I mean
[CUSTOMER][NEUTRAL] Can you check the image? Can you pull up what we sent you and see if it's only the claim form that was received or if, if the EOB is there and it was overlooked because it happens at times.
[AGENT][NEUTRAL] Sure, give me just a moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, no, we just received the one form or we have nothing from their primary.
[CUSTOMER][POSITIVE] OK. Thank you so much for checking. And what's timely filing to submit the primary EOB?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] Thank you. Address, fax number, please?
[AGENT][NEUTRAL] Uh, mailing address is [PII].
[AGENT][NEUTRAL] Uh, excuse me, yes, [PII].
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm thank you. And fax number, please?
[AGENT][NEUTRAL] Fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Thank you. And can you provide me the eligibility date, please?
[AGENT][NEUTRAL] Yes and I will say the original policy number that you had given me was an older policy um so whenever you're ready I can give you this current policy number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For [PII]?
[AGENT][NEUTRAL] That was active during this state of service, yes.
[CUSTOMER][NEUTRAL] OK, please. May I have that, please?
[AGENT][NEUTRAL] That is
[AGENT][NEUTRAL] 02.
[AGENT][NEUTRAL] 4566.
[AGENT][NEUTRAL] 84
[CUSTOMER][NEUTRAL] 02456684. Does it have any alpha in there like alphabet?
[AGENT][NEUTRAL] No, those are gonna be to differentiate between uh outpatient or inpatient services, the ML 8 or 7, the digits before the M or the actual policy number.
[CUSTOMER][NEUTRAL] OK, so 02456684. What's the effective date for this one?
[AGENT][NEUTRAL] Effective date was [PII] and it is currently active.
[CUSTOMER][POSITIVE] Thank you. And the one that I provided you, what's the start and end date for that one?
[AGENT][NEUTRAL] Oh sure, give me just a moment let me get that.
[AGENT][NEUTRAL] That was an effective date [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that term date was [PII].
[CUSTOMER][POSITIVE] Thank you so much. Appreciate that. And a call reference number, please.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial and today's date and so my name is spelled [PII]
[AGENT][NEUTRAL] Was there anything else I could help you with?
[CUSTOMER][POSITIVE] [PII]. That's gonna be all. Thank you so much. Appreciate it.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. You too, [PII]. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.