AccountId: 011433970860
ContactId: 7771bb13-b8d4-4fe9-85f9-3cb7e91b5eae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270130 ms
Total Talk Time (AGENT): 97418 ms
Total Talk Time (CUSTOMER): 112171 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/7771bb13-b8d4-4fe9-85f9-3cb7e91b5eae_20250605T13:50_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I'm calling from provider's office a claim which was denied.
[AGENT][NEUTRAL] OK, sure. I can assist you with claims and may I have your name one more time?
[CUSTOMER][NEUTRAL] Are you?
[CUSTOMER][NEUTRAL] Yeah, it's [PII], spelled as [PII]
[AGENT][NEUTRAL] OK. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. It's a direct line.
[AGENT][NEUTRAL] OK. And what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] up
[CUSTOMER][NEUTRAL] I'm calling from Advent Health Orlando.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah. It is 251-820-3.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah, so the claims date of service is [PII].
[CUSTOMER][NEUTRAL] She
[CUSTOMER][NEUTRAL] I start.
[AGENT][NEUTRAL] OK. Can you repeat that one more time? You said [PII]?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. How much is the total charge?
[CUSTOMER][NEUTRAL] It's $91,450.57.
[AGENT][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and if so for future, you can check claim status online through our website at [PII], that's just optional.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] still.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like we are needing the primary explanation of benefits to continue the processing of this claim. So once we receive the copy of the primary explanation of benefits, we'll reprocess the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So the claim is pending for primary explanation of benefits, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Can you please help me with the mailing address so that we can send out.
[AGENT][NEUTRAL] Sure, the mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. What would be the attention to?
[AGENT][NEUTRAL] It will be APL claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, um, can you please help me with the timely filing you to send the information?
[AGENT][NEUTRAL] We don't have timely final limit for you to submit an LB a primary ELP.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My
[CUSTOMER][NEUTRAL] And one.
[AGENT][NEUTRAL] Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] So, yeah, that's it from my end. Thank you so much for the information. So can you please help me with your name and call reference number?
[AGENT][NEUTRAL] OK, we don't have a reference numbers. You can use my name in today's date. My name is So, that's [PII]. Last initial is [PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][POSITIVE] Got it. Thank you so much for the information. Have a wonderful day and goodbye.
[AGENT][POSITIVE] You as well thank you for calling APO bye bye.