AccountId: 011433970860
ContactId: 5d409d2c-cf1f-4b0e-9d58-fd9d7d6b9f8b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 475700 ms
Total Talk Time (AGENT): 144122 ms
Total Talk Time (CUSTOMER): 143980 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/5d409d2c-cf1f-4b0e-9d58-fd9d7d6b9f8b_20250408T18:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, I'm calling from provider office to check on claim insurance.
[AGENT][NEUTRAL] Yeah, I can assist you. What's your first name?
[CUSTOMER][NEUTRAL] My name is gonna be [PII], and my last name [PII] is gonna be [PII].
[AGENT][NEUTRAL] OK, so the spelling of your first name is just the letter [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said that you're checking claim status?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Oh, actually, uh, recently we have send you guys a fax, so I just want a fax status.
[AGENT][NEUTRAL] You're calling to verify if we received the claim?
[CUSTOMER][NEUTRAL] just so much. Actually, uh, we have got to know that the claim, uh, which you have received as an IA primary EUB, so we have sent the primary EUB to you guys.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so you're verifying if we've received the ELB and then if it's been processed, got it. What is the policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Uh, yes, but before going ahead, I would like to say this call has been recorded for the quality and training purposes. Is that OK to you?
[AGENT][NEUTRAL] Yeah, that's fine.
[CUSTOMER][POSITIVE] Thank you. Oh, so the.
[CUSTOMER][NEUTRAL] Policy number starts with 2 02464681 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] And what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] OK, thank you. And what's the date of service of the claim?
[CUSTOMER][NEUTRAL] It's gonna be [PII], total charge of $379.
[AGENT][NEUTRAL] 379 even.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, you kind of went away.
[AGENT][NEUTRAL] And if you could verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, this name is gonna be [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. Date of birth of [PII].
[AGENT][NEUTRAL] OK, thank you for that information. When was the primary EOB submitted to us?
[CUSTOMER][NEUTRAL] It was submitted on [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Alright, so I show the information was received.
[AGENT][NEUTRAL] And what's the name of the medical center?
[CUSTOMER][NEUTRAL] It's gonna be virtual MD Group Holding LLC.
[AGENT][NEUTRAL] I'm sorry, what is it?
[CUSTOMER][NEUTRAL] Oh, just a moment
[CUSTOMER][NEUTRAL] It's gonna be Viel V I T A L M D group holding I will see.
[AGENT][NEUTRAL] OK, so you gave me date of service [PII]. The total bill was for 379.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah I see that data service in the charge but the provider's name is different.
[CUSTOMER][NEUTRAL] Just a moment, you are, do you want the rendering provider name or the facility name?
[AGENT][NEUTRAL] The facility, the billing address, the billing name.
[CUSTOMER][NEUTRAL] Yeah, I, uh, yes, it's correct. It is, I'm calling from YLMD Group holding LLC.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] There's no other name.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And can you verify the tax ID number?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] OK, so Miss, I show that data of service with the total charge, but the, the provider's name is different and that tax ID number is this different than what we have.
[AGENT][NEUTRAL] So I'm gonna say that this is not your claim?
[CUSTOMER][NEUTRAL] Basically, we do have.
[AGENT][NEUTRAL] What's the procedure code on the claim?
[CUSTOMER][NEUTRAL] It's gonna be 76816. I do have the claim number too.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I see a claim but the provider's name that you're giving me and the tax ID number is different than what we have on file.
[CUSTOMER][NEUTRAL] But ma'am, actually we do have only one provider for us.
[AGENT][NEUTRAL] Yeah, I'm just stating what the information says that's all.
[CUSTOMER][NEUTRAL] We don't
[CUSTOMER][NEUTRAL] 516.
[CUSTOMER][NEUTRAL] OK, just a moment please.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Uh, OK, can I get the call reference number from your side?
[AGENT][NEUTRAL] It's gonna be my name in today's date, [PII]
[AGENT][NEUTRAL] And first initial of my last name is [PII], and can you repeat the tax ID number for me again?
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Yes, just one.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] OK, give me just a second, OK?
[AGENT][NEUTRAL] That information is on the initial claim.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] Bear with me one moment.
[AGENT][NEUTRAL] Alright, [PII], thank you for holding. I'm gonna have to send this claim back through for review.
[AGENT][NEUTRAL] Um, I do show that we did, we did receive the explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And is it Blue Cross Florida Blues or primary?
[CUSTOMER][NEUTRAL] Just some
[CUSTOMER][NEUTRAL] Yes, it's gonna be Blue Cross Blue Shield Primary.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And um we'll give you a call back um at the number you provided the [PII], is that right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] She's gonna have it uh someone take a look at this claim and then we'll be giving you a call back OK?
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Oh, you're welcome. Anything else I can help with today?
[CUSTOMER][POSITIVE] No, thank you so much. I had only one thing thank you.
[AGENT][POSITIVE] Uh, you're welcome. Thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Have a great day too.
[AGENT][NEUTRAL] OK. Bye-bye.