AccountId: 011433970860
ContactId: 877a29f9-d0af-4fa2-bb98-9ed7077889a2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 604119 ms
Total Talk Time (AGENT): 261179 ms
Total Talk Time (CUSTOMER): 105500 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/877a29f9-d0af-4fa2-bb98-9ed7077889a2_20250116T15:31_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office to check on our claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Can I get a good call back number for you?
[CUSTOMER][NEUTRAL] Sure. [PII]. And may I get your name? Sorry, I missed out.
[AGENT][NEUTRAL] Sure, it was [PII], last initials [PII]
[CUSTOMER][POSITIVE] [PII] Thank you.
[AGENT][NEUTRAL] And uh you're welcome um what provider's office are you calling from?
[CUSTOMER][NEUTRAL] One moment. I'm calling from the provider's office, HCA Florida West Side Hospital.
[AGENT][NEUTRAL] OK, and do you have the um policy number for the patient you need status on?
[CUSTOMER][NEUTRAL] Yes, it is a follow-up claim. Do you need the claim number or the policy number?
[AGENT][NEUTRAL] Uh, whichever one's easier for you.
[CUSTOMER][NEUTRAL] OK. Claim number?
[CUSTOMER][NEUTRAL] 348-5205
[AGENT][NEUTRAL] OK, give me just one moment to get that pulled up.
[AGENT][NEUTRAL] OK, can you verify that patient's name and date of birth for me?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] It is [PII]. Date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, it looks like we previously denied that claim as needing the EOB so let me see if anything has come in for that and if we've processed it.
[CUSTOMER][NEUTRAL] Yes, we have sent it on [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, I'm gonna write down a few other claim numbers here just to review them and see.
[AGENT][NEUTRAL] When we received them and when we um processed them that way I can determine if what you sent um it does look like we have some mail that has not yet been processed that was received um yesterday on the [PII] um so if I had to guess, let me actually just go over there and find that.
[CUSTOMER][NEUTRAL] Uh, did you receive the explanation of benefits today?
[AGENT][NEUTRAL] Um, I'm looking at that now. It looks like we, um, did receive something yesterday. I just need to review and make sure that that EOB came through.
[CUSTOMER][NEUTRAL] Sure, take it down.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I did find that mail and it is loading now, so let's see here.
[AGENT][NEGATIVE] Sorry I've been having some technical issues this morning so it's been really slow for me.
[AGENT][NEUTRAL] There it goes, OK.
[AGENT][NEUTRAL] OK, yes, it does look like we received um that EOB um so we do ask that you allow 7 to 10 business days for processing, um, and with it being received just yesterday it is here and in line for processing, um, it just may not um be pulled just yet we do try to you know get to all of our clients as soon as we can, um, but we do ask that you allow.
[AGENT][NEUTRAL] Um, 7 to 10 business days.
[CUSTOMER][NEUTRAL] Sure. I do have one more claim. Can you please assist me with that claim status also?
[AGENT][NEUTRAL] Sure, is it for the same patient or a different one?
[CUSTOMER][NEUTRAL] Different one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have that policy number or just a claim number?
[CUSTOMER][NEUTRAL] Uh, let me check that here. I have bought the one.
[AGENT][NEUTRAL] OK, um, whichever one's easier for you, you just let me know.
[CUSTOMER][NEUTRAL] Let me go ahead and get the claim number. It is 353-393-1.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and can you verify that patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] OK, and it looks like it was the same original denial on that claim. Um, when was that EOB sent?
[CUSTOMER][NEUTRAL] So, the explanation of benefits was sent on the same date of [PII].
[AGENT][NEUTRAL] OK, so let me go back over here and review and see if we found that as well.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, it looks like we have received it, um, let me see.
[AGENT][NEUTRAL] Make sure that that EOB came through.
[AGENT][NEUTRAL] Let's see
[AGENT][NEUTRAL] I'm sorry, bear with me.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] You have received the rate?
[AGENT][NEUTRAL] Um, it is showing that it was received, um, but I'm trying to find it, honestly, um.
[AGENT][NEUTRAL] Because I'm showing that it has been um.
[AGENT][NEUTRAL] Received as far as looking at the policy number, but when I go to review that mail to see if it's there it's not wanting to pull anything for me so I'm just trying to confirm that we received it um because it's not loading in my system that anything is there it could just be that it's in the process of being moved over um from.
[AGENT][NEUTRAL] Our indexing to our processing screens, um, I do show that mail has been received at this time. I'm just not able to verify if.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] If it's there or not, um, so I would allow time for that as well because like I said, I am showing that mail was received and your other fax was received successfully so hopefully that's the case for this one as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So it is also for the same turnaround time, 7 to 10 business days?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Thank you so much. May I get the call reference number?
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] Yeah, it would just be my name with today's date. And is there anything else I can do for you today, Miss [PII]?
[CUSTOMER][POSITIVE] No, I have got all the required information. Thank you so much. Have a good day. Take care. Bye for now.
[AGENT][POSITIVE] Thank you bye bye have a great day and thanks for calling APO.
[CUSTOMER][NEUTRAL] Mhm bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] Sure, thank you.