AccountId: 011433970860
ContactId: 888abc45-9942-4c64-be54-1bfc155a1dd5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286839 ms
Total Talk Time (AGENT): 107420 ms
Total Talk Time (CUSTOMER): 115803 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/888abc45-9942-4c64-be54-1bfc155a1dd5_20250422T20:46_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from provider's office to check on our client status. How are you doing today?
[CUSTOMER][NEUTRAL] Hello, [PII].
[AGENT][NEUTRAL] Hello, [PII], can you hear me?
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Yes, now I can hear you.
[AGENT][POSITIVE] OK, um, I'm sorry about that, my phone went in and out, but I'm doing well today. How are you?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] I'm good, thank you for asking.
[AGENT][POSITIVE] Good, and I'll be more than happy to help you with the claim status. May I have a good contact number in case we're disconnected?
[CUSTOMER][POSITIVE] Good, and I'll be more than happy to help you with the claim status.
[CUSTOMER][NEUTRAL] Yes, it's [PII]. Direct line, no extension.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, my policy number is 01979893.
[CUSTOMER][NEUTRAL] M. as Mike. L as Lima number 7.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Gal, uh it's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim you'd like me to look at with you?
[CUSTOMER][NEUTRAL] Uh sure. The date of service is um
[CUSTOMER][NEUTRAL] [PII] and the bill amount is $14,368 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] It's the Florida Mercy Hospital.
[AGENT][NEUTRAL] OK, I have it here. So I'm showing that we received the claim on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 353.
[AGENT][NEUTRAL] 0245.
[AGENT][NEUTRAL] And on [PII], the claim was denied, requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. So, could you please tell me the mailing address and the fax number to send the primary OB?
[AGENT][NEUTRAL] Sure. So the fax number is 877.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] 3.
[AGENT][NEUTRAL] And that'll be attention APL claims department.
[AGENT][NEUTRAL] And then our mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] The zip code is [PII]
[CUSTOMER][NEUTRAL] And could you please tell me, uh spell the, OK, [PII]. OK, I got that. So what will be the turnaround time?
[AGENT][NEUTRAL] Of
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] The turnaround, you're requesting the turnaround time for, I don't understand the question. Once we receive the explanation of benefits or?
[CUSTOMER][NEUTRAL] I don't uh, for the
[CUSTOMER][POSITIVE] OK, thank you. Thank you for your time and assistance. So, could you please also provide me the
[AGENT][NEUTRAL] No, I'm asking.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I just need, uh, is there any time, time filing limit to send, uh, submit the primary UB? That's what my question is.
[AGENT][NEUTRAL] No, there's no timely filing limit as long as the policy is active on the data service.
[CUSTOMER][NEGATIVE] No, there's no time with that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you. That's it for today. Could you please also provide me the call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date and then again that's [PII], first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] So this is
[CUSTOMER][POSITIVE] OK, and thank you. Thank you for your time and assistance. Have a great day.
[AGENT][POSITIVE] Thank you, you also, sir, and thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Thank you you
[CUSTOMER][POSITIVE] Thank you