AccountId: 011433970860
ContactId: 7f9dcd6a-affe-4cf1-bad8-3cc0333042f8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 395309 ms
Total Talk Time (AGENT): 116866 ms
Total Talk Time (CUSTOMER): 91412 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/7f9dcd6a-affe-4cf1-bad8-3cc0333042f8_20250515T18:10_UTC.wav
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[AGENT][POSITIVE] Thank you for
[AGENT][NEUTRAL] Well, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check claim status.
[AGENT][NEUTRAL] OK [PII], I can help you with claim status. May I please get your call back number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Is my callback.
[CUSTOMER][NEUTRAL] Yes, my callback number is [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you, Miss [PII], and what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] The member's name is [PII] and date of birth is.
[CUSTOMER][NEUTRAL] [PII] and the policy number is 01873939 M as in Mike L as in Lima number 8.
[AGENT][NEUTRAL] OK, let me pull up that policy for us real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and um.
[AGENT][NEUTRAL] What is the data service and the charge amount?
[CUSTOMER][NEUTRAL] The date of service is [PII]. And the total bill amount is
[CUSTOMER][NEUTRAL] $16,303.63.
[AGENT][NEUTRAL] Thank you and what are the charges after the primary insurance paid?
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] 800 even.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] OK, and then have the with the facility you're calling from.
[CUSTOMER][NEUTRAL] The facility name is HSCA Florida Western Marian Hospital.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look up this claim for you, Miss [PII] and I will be right back.
[CUSTOMER][NEUTRAL] Yes, you need the data service?
[AGENT][NEUTRAL] You gave it to me [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I can hold for 2. You are on hold.
[AGENT][POSITIVE] Thank you
[AGENT][NEUTRAL] Yes ma'am. What were you saying you can also what?
[CUSTOMER][NEUTRAL] Yeah, I can hold for 2 minutes.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look up the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, [PII]. Look looking at the claim, I have the claim number for you.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] And when this claim was received?
[AGENT][NEUTRAL] The claim number is.
[AGENT][NEUTRAL] OK, let me give you the claim number first. It's 354.
[AGENT][NEUTRAL] 2746.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] And we received the claim on [PII] and processed it on [PII].
[AGENT][NEUTRAL] And the claim has been denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Uh, we have already centered on [PII]. Could you please verify that?
[AGENT][NEUTRAL] No ma'am, I do not see that it's been sent.
[CUSTOMER][NEUTRAL] Actually, it's been only 2 days. It was entered through the meeting.
[AGENT][NEUTRAL] On that day.
[AGENT][NEUTRAL] OK, it does take 7 to 10 days to process, so you may be calling a little soon.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Uh, it will take 7 to 10 days, right?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK. Can I get the call reference?
[AGENT][NEUTRAL] Is there anything else I can help you with, [PII], before we go?
[AGENT][NEUTRAL] Yes, you can use my name to [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you. Thank you so much for your time and assistance. Have a great day.
[AGENT][POSITIVE] You too [PII] you have a blessed one and thanks for calling APL.
[AGENT][NEUTRAL] Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.