AccountId: 011433970860
ContactId: 7338cd43-5ca2-429e-8721-00c25f8da771
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 577559 ms
Total Talk Time (AGENT): 287702 ms
Total Talk Time (CUSTOMER): 172137 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/7338cd43-5ca2-429e-8721-00c25f8da771_20250205T20:20_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]. My name is [PII] with [PII]. I'm trying to find out the status of the claim we filed, please.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with that claim status. What is the callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] 022 03963 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please, ma'am.
[CUSTOMER][NEUTRAL] I'm gonna spell it. It's [PII] The last name is, is [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] And I guess the date of birth is [PII]. That's my best shot.
[AGENT][POSITIVE] Alright, thank you. Sounded good to me when you said you were gonna spell it, I said I better I know which.
[CUSTOMER][NEUTRAL] Which name?
[AGENT][NEUTRAL] Dependent that's on, yeah.
[AGENT][POSITIVE] And it would be my pleasure to help you with that claim status, [PII]. What is the data service?
[CUSTOMER][NEUTRAL] Uh, 919-2024, total amount billed was $1500 and this is a secondary toigna.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what is the facility name?
[CUSTOMER][NEUTRAL] Uh, Florida Eye and Microsurgical Institute.
[CUSTOMER][NEUTRAL] they had the, the surgery at West Boca Medical Center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm checking on that, bear with me just a second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For 9-1924 I don't have a facility claim on file.
[CUSTOMER][NEUTRAL] It's not, it's a physician.
[AGENT][NEUTRAL] A position
[CUSTOMER][NEUTRAL] I just said, yeah.
[AGENT][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] For Doctor [PII] for Florida Eye and Microsurgical Institute.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] We had called on [PII] and they stated that the claim was not on file, so they gave me a fax number and that was faxed over.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I can give you the fax number if you need that.
[AGENT][NEUTRAL] what was that bill amount again?
[CUSTOMER][NEUTRAL] The total bill amount was $1500. Um, the amount remaining is $502.75.
[AGENT][NEUTRAL] OK, let me, let me check just another minute if you don't mind.
[CUSTOMER][POSITIVE] Not at all, take your time.
[AGENT][NEUTRAL] And I said I don't see a facility claim. Was it for inpatient or outpatient?
[CUSTOMER][NEUTRAL] Outpatient, and again, it's not a facility, it's the physician, a professor.
[AGENT][POSITIVE] Got you, got you.
[AGENT][NEUTRAL] I'm just trying to see what's going on cause I have.
[AGENT][NEUTRAL] Several dates of service that's what I was looking at.
[CUSTOMER][NEUTRAL] Now we
[CUSTOMER][NEUTRAL] We did fax it um to an [PII] and it did go through.
[AGENT][NEUTRAL] And that was on [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] I can give you the exact time.
[AGENT][NEUTRAL] So what is OK.
[AGENT][NEUTRAL] Hang on.
[AGENT][NEUTRAL] I mean, I see the claim. Uh, I'm, I'm, I'm sitting here wondering myself, why is it not coming up? That, uh, so it's not you, it's me. There's something going on with my system. I didn't pull it up. But I do have that fly, Florida fly. Oh gosh. Florida, I microsurgical institute.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Girl, it's almost time to get off.
[AGENT][POSITIVE] And we did receive it on the [PII] and it's been processed and paid. Let me give you that process date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it was processed and paid on [PII] for the in the amount of 50275.
[CUSTOMER][NEUTRAL] Was it a physical check?
[AGENT][NEUTRAL] For the CPT 667311? Yeah.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Can you verify where it was mailed?
[AGENT][NEUTRAL] It was
[AGENT][NEUTRAL] That's what I'm getting pulled up now. [PII].
[CUSTOMER][NEUTRAL] Yeah, that's correct. Can you tell if it was cash?
[AGENT][NEGATIVE] Does not look like it's cleared.
[CUSTOMER][NEUTRAL] Yeah, I don't think we got it because I process all the checks that come in and
[AGENT][NEUTRAL] I tell you what, let's do.
[AGENT][NEUTRAL] Let's give me just one second. Let's get that um check voided and reissued, and you're saying that is the correct address?
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII].
[AGENT][NEUTRAL] OK, so I'm gonna put in a request that we void that check and reissue. Now let me give you the claim number and the check number now just know that if you receive that um.
[AGENT][NEUTRAL] Check, you'll not be able to clear it if you find it, I mean cash it if you find it because we're fixing to.
[CUSTOMER][NEUTRAL] They don't send it out like a couple weeks later, right? I mean, they would have sent it.
[AGENT][NEUTRAL] Mm mm, it goes out the next day.
[CUSTOMER][NEGATIVE] Yeah, no, we, we did not receive that.
[AGENT][NEUTRAL] It probably went to [PII] before it.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Oh lucky [PII].
[AGENT][POSITIVE] I know, let's go get it
[CUSTOMER][NEUTRAL] I can you.
[AGENT][NEUTRAL] Uh, it's probably sitting in a mail truck some, no, I shouldn't say that. I'm so sorry. I shouldn't say that.
[CUSTOMER][POSITIVE] Yeah, you're probably right, and we should go get it.
[AGENT][NEUTRAL] Especially if it's in [PII].
[AGENT][NEUTRAL] If you'll bear with me just one second, I'm putting that request in and I'd like to do it while I've got you on the phone that way you know and I know.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That you're fixing to get that taken care of.
[AGENT][NEUTRAL] Give me just a second.
[AGENT][NEUTRAL] I'm gonna give you the, I reckon I could give you that check number and everything while I've got you holding, bear with me, give me just a second. Let me get this part.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Taken care of and then we'll give you that information.
[AGENT][NEUTRAL] Now, I would tell you normally to have that done, it could take up to 7 to 10 days, but.
[AGENT][NEUTRAL] Normally, it's a little bit quicker than that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just depends on when we get that information back from our finance department, they do have to verify that it has not cleared.
[AGENT][NEUTRAL] OK, so let me give you the check number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The reissued check number or the old check numbers.
[AGENT][NEUTRAL] This is gonna be the old check nu[PII], so just in case you happen to find that check or whatever, you'll have the check numbers so you'll know that that's the one you cannot.
[AGENT][NEGATIVE] Um, it won't go through because it's gonna be voided.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the check number is 201.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 852-3
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And again, what was the date that it was paid?
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] The date of the test?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is the claim number gonna be the same?
[AGENT][NEUTRAL] It's gonna be a different claim number but there uh I'm still gonna give you everything just so you have it and.
[AGENT][POSITIVE] And you can even call back and check claim status if you want to in a couple of days that's fine as well but at least you'll have the claim number just tell them it's gonna be reissued they can pull up that information and then check it a lot easier.
[AGENT][NEUTRAL] Um, the claim number.
[AGENT][NEUTRAL] Is 354.
[AGENT][NEUTRAL] 91. I'm so sorry. Let me try that again. 3541197.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 5411997, did you say?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I still say we should have got it, got it.
[AGENT][NEUTRAL] Yeah, I
[CUSTOMER][NEUTRAL] That would have been the efficient thing to do.
[AGENT][NEUTRAL] Yeah, so
[AGENT][NEUTRAL] Um, but that paid amount was 50275.
[CUSTOMER][POSITIVE] OK, awesome.
[CUSTOMER][NEUTRAL] Do you have a confirmation number by chance that I spoke with you?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] You can use my name in today's date, and I spell my name [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And it has been a pleasure to assist you with that claim information and this uh request has already been submitted.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Awesome, same here.
[CUSTOMER][POSITIVE] No, ma'am, that's it. You have a blessed day.
[AGENT][POSITIVE] I hope you do too. It was a pleasure to assist you and thank you for calling APL. Take care and have a wonderful afternoon.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.