AccountId: 011433970860
ContactId: 7f5ef507-5c91-4bad-bbb2-f3d202bdcfcb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 302230 ms
Total Talk Time (AGENT): 96347 ms
Total Talk Time (CUSTOMER): 91251 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/7f5ef507-5c91-4bad-bbb2-f3d202bdcfcb_20250327T14:05_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] How's it going? This is [PII]. I'm calling from [PII]'s office. I'm trying to get the denial reason of a claim.
[AGENT][NEUTRAL] OK, [PII], I can help you with that claim status. Um, do you have the policy number for the patient and a good callback number for yourself?
[CUSTOMER][NEUTRAL] Policy number is 2203918 and then the callback number is [PII].
[AGENT][NEUTRAL] And do you have the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] and I'm sorry, what was your name again, ma'am?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And what was that date of service?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Um, it looks like and what was the or the provider on that?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The provider is ACF Florida Northwest Hospital and I'm sorry, what was the other question?
[AGENT][NEUTRAL] Oh, just who is the provider?
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] I do you have the claim number on that? Did you get an EOB?
[CUSTOMER][NEUTRAL] Yeah, I do, uh, claim number is 243-725-491600.
[AGENT][NEUTRAL] OK, that's not our claim number, um.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] What were the bill charges? I'm sorry, I think you told me that, but I'm, I missed it.
[CUSTOMER][NEUTRAL] You're fine the bill charges.
[CUSTOMER][NEUTRAL] Uh, $7,169 even.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] Yeah, I, I don't see a claim for that amount. Um, it was a facility claim.
[CUSTOMER][NEUTRAL] Yeah, and then so far actually as I see over here this EOV is for other insurance actually give me one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So probably that's why you don't have this claim number.
[AGENT][NEUTRAL] Yeah, and I don't see that, uh, I don't see that claim on file actually. I've got some.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Other claims for that or other charges for that date but not a facility claim.
[CUSTOMER][NEUTRAL] Can you start with 354-7321?
[AGENT][NEUTRAL] 547321.
[AGENT][NEUTRAL] Let's see
[CUSTOMER][NEUTRAL] 3212. I'm sorry 31. I repeat that back 354-7312.
[AGENT][NEUTRAL] 7312. OK, let's try it.
[AGENT][NEUTRAL] 3547312.
[AGENT][NEUTRAL] OK, now I see it. All right, let's see what's going on here.
[CUSTOMER][NEUTRAL] what
[AGENT][NEUTRAL] Uh, looks like we need a copy of the primary explanation of benefits.
[CUSTOMER][NEUTRAL] When you guys received the claim?
[AGENT][NEUTRAL] Uh, we received the.
[AGENT][NEUTRAL] Received on [PII] and then that was denied [PII].
[CUSTOMER][NEUTRAL] 859.
[CUSTOMER][NEUTRAL] From where you be needed.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, you guys receive that through fax?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, yeah, I mean you can fax the primary OB, is that what you're asking?
[CUSTOMER][NEUTRAL] Oh, OK, what's the fax number?
[AGENT][NEUTRAL] Fax number is [PII].
[CUSTOMER][POSITIVE] Thank you man appreciate it. Is there any reference number?
[AGENT][NEUTRAL] Uh, reference number is just my first name, last initial, today's date. Is there anything else I can help with today?
[CUSTOMER][NEUTRAL] What's your last initial?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Alright, no, that should be it, man. I appreciate it.
[AGENT][POSITIVE] OK, thanks for calling APL have a great day.
[CUSTOMER][NEUTRAL] Same for you.
[AGENT][NEUTRAL] Bye.