AccountId: 011433970860
ContactId: 6f43847b-fe42-4c81-95c5-44c3f9a8b172
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 379410 ms
Total Talk Time (AGENT): 106108 ms
Total Talk Time (CUSTOMER): 92638 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/6f43847b-fe42-4c81-95c5-44c3f9a8b172_20250528T21:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from the provider's office to check on the claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status, and what was your name again?
[CUSTOMER][NEUTRAL] Uh my name is [PII]. You can spell it as [PII] and first initial of my last name is [PII].
[AGENT][POSITIVE] Thank you so much, Ms. [PII], and then what is your callback number, ma'am just in case the call is disconnected.
[CUSTOMER][NEUTRAL] Oh yeah, that would be [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you. And then may I please get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yeah. So the uh policy ID for the member is 02230003 and name of the member is [PII] and date of birth is on [PII].
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and then may I have um [PII]'s date of service and charge amount?
[CUSTOMER][NEUTRAL] Yeah, with the show, and that would be.
[CUSTOMER][NEUTRAL] On [PII]. And the total bill amount is $124,916 in evening.
[AGENT][NEUTRAL] Thank you. And then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Um, that would be $559.55.
[AGENT][NEUTRAL] Thank you and then can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Sure. That would be
[CUSTOMER][NEUTRAL] HC Florida Mercy Hospital.
[AGENT][NEUTRAL] Thank you. I'm gonna look this claim up Ms. [PII], and I will be right back. I'm gonna put you on a brief hold, OK?
[CUSTOMER][NEUTRAL] Mhm
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, [PII]. So looking on data service of 1023 24 through [PII] of 24, I found claim number.
[AGENT][NEUTRAL] 3554823.
[AGENT][NEUTRAL] And the claim has been denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] OK, sir. When did you receive the claim and when it got denied?
[AGENT][NEUTRAL] Let me let you know.
[AGENT][NEUTRAL] Let me look it up real quick.
[AGENT][NEUTRAL] We received the claim on [PII] and processed it on [PII].
[CUSTOMER][NEUTRAL] OK. So upon checking, we've been uh already sent the primary UOB uh through fax. Uh, the fax number is [PII] on [PII]. Have you received it?
[AGENT][NEUTRAL] Uh, if it was just sent yesterday, it hasn't shown up for me yet. Once we receive the information, it does take 7 to 10 business days to process the claim.
[AGENT][NEUTRAL] And [PII] was just yesterday.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK. I'm ready for the call reference number.
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] in today's date.
[CUSTOMER][POSITIVE] OK, got it. Thank you so much for your information, [PII]. Have a great day. Take care. Bye-bye.
[AGENT][POSITIVE] You too [PII] you have a blessed night and thank you for calling APL bye bye ma'am.