AccountId: 011433970860
ContactId: 736bdab4-fe76-44b5-b424-1742bd5cc81e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 596950 ms
Total Talk Time (AGENT): 204921 ms
Total Talk Time (CUSTOMER): 258842 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/736bdab4-fe76-44b5-b424-1742bd5cc81e_20250221T14:31_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], calling on behalf of provider's office to check on a claim status.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you with that claim status. What is a good callback number?
[CUSTOMER][NEUTRAL] The callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Yes, sure. The policy number is 2263406.
[AGENT][NEUTRAL] And what is the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] The patient name is?
[CUSTOMER][NEUTRAL] So [PII]. And the date of birth is [PII].
[AGENT][POSITIVE] Alright, and it would be a pleasure to assist you with that claim status, [PII]. What is the date of service?
[CUSTOMER][NEUTRAL] The date of service is [PII].
[AGENT][NEUTRAL] And the build out please, ma'am.
[CUSTOMER][NEUTRAL] The total bill amount is $41,783.
[AGENT][NEUTRAL] And what is the facility name, please?
[CUSTOMER][NEUTRAL] The facility name is HCA Florida.
[CUSTOMER][NEUTRAL] One moment, please.
[CUSTOMER][NEUTRAL] It's HCA Florida, John F. Kennedy Hospital.
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] And [PII], we did receive that claim on [PII].
[AGENT][NEUTRAL] It was processed on [PII]. Now this claim is pending for the primary EOB. We are secondary.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. So it has been pending for the primary UB, right? So, may I know how we can send the primary UB through fax or mail?
[AGENT][POSITIVE] That is good.
[AGENT][NEUTRAL] You, you can definitely fax that directly to our claims department.
[AGENT][NEUTRAL] Our fax number is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Thank you. Is there any attention?
[AGENT][NEUTRAL] It comes straight to our claims department.
[CUSTOMER][NEUTRAL] OK. And uh is there any time limit?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] OK, so we can.
[CUSTOMER][NEUTRAL] One moment. OK. So we can send the primary UB alone, or do we need to send the UB 04 form along with the primary OB?
[AGENT][NEUTRAL] You can just send the primary EOB reference and the policy number and the claim number. Can I give you that claim number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, sure.
[AGENT][NEUTRAL] The claim number is 354.
[AGENT][NEUTRAL] 8692.
[CUSTOMER][NEUTRAL] Thank you. And may I know the call reference number for this one?
[AGENT][NEUTRAL] Call reference number is my name in today's date, and I spell my name.
[CUSTOMER][NEUTRAL] Could you please spell out your name.
[AGENT][NEUTRAL] Yes, ma'am. It is [PII].
[CUSTOMER][POSITIVE] Thank you so much. So, may I know in one call how many claims status you will provide?
[AGENT][NEUTRAL] How many do you have, [PII]?
[CUSTOMER][NEUTRAL] Uh, give me a moment. Let me check.
[CUSTOMER][NEUTRAL] I'm having one more claim. Could you please help me with that also?
[AGENT][POSITIVE] It would be my pleasure to assist you with another claim, [PII]. I am ready for that policy number whenever you are.
[CUSTOMER][NEUTRAL] Yes, one moment.
[CUSTOMER][NEUTRAL] OK. Yes. Uh, the policy number is 02446503.
[AGENT][NEUTRAL] And what is the name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] The date, OK. The patient name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you, [PII], and that data service please, ma'am.
[CUSTOMER][NEUTRAL] Yeah, sure. The date of service is [PII].
[AGENT][NEUTRAL] And that amount.
[CUSTOMER][NEUTRAL] The total bill amount for this one is $22,858 even.
[AGENT][NEUTRAL] And that is for the same facility?
[CUSTOMER][NEUTRAL] No, it's for children Medical Center.
[CUSTOMER][NEUTRAL] To do that
[AGENT][NEUTRAL] And you said that is for 9-25-2024?
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] And what was that bill amount?
[CUSTOMER][NEUTRAL] The amount is, uh, one moment, let me check once again. Uh, it's $22,858 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm checking on that claim if you'll bear with me just one moment please, ma'am.
[CUSTOMER][POSITIVE] Yeah, sure. Take your time.
[AGENT][NEUTRAL] I have a claim from that provider for that amount, but not that data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, OK. One moment. Let me check.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You said the date of service is different, right?
[AGENT][NEUTRAL] Is it a date range?
[CUSTOMER][NEUTRAL] No, it's for the single date. And uh
[CUSTOMER][NEUTRAL] We have received on color and it states primary will be needed.
[AGENT][NEUTRAL] Do you have that claim number?
[CUSTOMER][NEUTRAL] OK, so you have
[CUSTOMER][NEUTRAL] Uh yes. So, the date of service you're having is 9/24, right?
[AGENT][NEUTRAL] That's correct. 924 through [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Give me a moment. Let me check. Yeah, that's right. Uh, the date of service is starts from, uh, [PII].
[AGENT][NEUTRAL] OK thank you alright yes ma'am we do have that claim and it is pending for the primary EOB as well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Primary UP. OK.
[CUSTOMER][NEUTRAL] Give me a moment. Let me check whether we have sent any primary previously.
[CUSTOMER][NEUTRAL] OK. We have sent on primary will be on [PII]. Could you please verify whether you have received it or?
[AGENT][NEUTRAL] We have not received it. Do you want to verify where it was sent? Was it faxed or mailed?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah. Give me a moment. It has been faxed by using the fax number [PII].
[AGENT][NEUTRAL] That is the correct fax number. However, we have not received that claim as of yet.
[CUSTOMER][NEUTRAL] OK. OK. Thank you so much. So we can send the primary UB through the fax number as you provided before, right? [PII].
[AGENT][NEUTRAL] That is
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. And the attention is uh clients department, right?
[AGENT][POSITIVE] Yes ma'am, that is correct.
[CUSTOMER][NEUTRAL] So, so we can send the primary you'll be alone itself, right?
[AGENT][NEUTRAL] That's right, just referencing the claim number and policy number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. So may I know the receipt date for this claim?
[AGENT][NEUTRAL] Yes, ma'am. The received date was [PII].
[AGENT][NEUTRAL] And processed on [PII].
[CUSTOMER][NEUTRAL] OK. So, OK, we can send the booking. Uh, could you please provide the claim number for this one?
[AGENT][NEUTRAL] Claim number 354.
[AGENT][NEUTRAL] 8692.
[CUSTOMER][NEUTRAL] 8692. OK, thank you. And the call reference number would be the same?
[AGENT][NEUTRAL] Yes, ma'am. It's my name in today's date.
[CUSTOMER][POSITIVE] OK. Thank you. Thank you, [PII]. Thank you for your assistance. Have a great day.
[AGENT][POSITIVE] My pleasure to assist you with that claim status, [PII], and also we do have a provider portal for claim status EOBs and claim submission that is at secured, that's SEC.
[AGENT][NEUTRAL] [PII] and if you have that um account activated, you can actually submit those EOBs online.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] My pleasure, [PII] and thank you for calling APL. I hope you have a lovely weekend.