AccountId: 011433970860
ContactId: 74558bbc-0b41-46cc-98e1-98ada430de1f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 287649 ms
Total Talk Time (AGENT): 111654 ms
Total Talk Time (CUSTOMER): 144704 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/74558bbc-0b41-46cc-98e1-98ada430de1f_20250331T14:52_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, uh my name is [PII]. It's [PII], and I'm calling from Naples Community Hospital in [PII] to see if you all received a claim from us as secondary um for a patient of ours, please.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, Ms. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, it's area code [PII], and that's my direct line.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes. Um,
[CUSTOMER][NEUTRAL] Uh, let's see, this is outpatient, um.
[CUSTOMER][NEGATIVE] I tried to use the portal and it said the the number wasn't right. I'm looking at the card and where it says it it it says um.
[CUSTOMER][NEUTRAL] Inpatient benefit certificate number and outpatient benefit certificate number, is that what you need?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, I need the outpatient.
[CUSTOMER][NEUTRAL] Starts with 023 OK 023.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] 00709 ML 8.
[AGENT][NEUTRAL] OK, thank you. And what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], uh, her date of birth is [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let me see, it looks like it was a therapy series date range, so let me look at the UV to get all of the dates. So it looks like the start date um was [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the ending date was [PII]. The total amount billed on the UB to Medicare was $3220 even.
[CUSTOMER][NEUTRAL] Not Medicare, I'm sorry. She's got Aetna Primary.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Yes, it's fine. Thank you.
[CUSTOMER][NEUTRAL] I'm so used to call on Medicare supplements.
[AGENT][NEUTRAL] Yeah, I understand. A lot of people, they just think it's this one, yeah, yeah, they're like, what, what letter? And I'm like, no letters.
[CUSTOMER][NEUTRAL] Right?
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] OK, let me see if I find that claim and that was [PII]. All right.
[AGENT][POSITIVE] OK, I believe it's gonna be this one.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] All right. So it looks like we received this claim on [PII] and the claim was um processed on the same date. It is missing the explanation of benefits from the primary insurance to continue the processing of this claim.
[CUSTOMER][POSITIVE] Oh, OK, good deal. Can I fax that over by any chance?
[AGENT][NEUTRAL] Mhm. Yes, you can. Yes, yes. And the fax number is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 3659423.
[CUSTOMER][NEUTRAL] 942-3 alright missing primary remit good deal. I will get that faxed over uh right now uh is there a uh call reference number that I need for our conversation today?
[AGENT][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, we don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] OK, and would you spell your name for me please?
[AGENT][NEUTRAL] Sure. Yes, that's [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much for your help this morning. I sure do appreciate it.
[AGENT][NEUTRAL] You're welcome, Ms. [PII]. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Uh, let me, let me just double check, make sure she doesn't have any other dates of service out there. Nope, that's the only one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, it's not.
[AGENT][NEUTRAL] All right. OK.
[CUSTOMER][POSITIVE] Thank you so much. I appreciate your help.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. You have a good day, good week.
[CUSTOMER][NEUTRAL] You too. Bye now.
[AGENT][POSITIVE] Thank you. Bye bye.