AccountId: 011433970860
ContactId: 929a185f-a0aa-46a6-9607-3be7a97c7933
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250000 ms
Total Talk Time (AGENT): 97735 ms
Total Talk Time (CUSTOMER): 99454 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/929a185f-a0aa-46a6-9607-3be7a97c7933_20250319T18:09_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]. My name is [PII] and I'm calling from the provider office regarding claim status.
[AGENT][POSITIVE] OK, well I'll be more than happy to help you with the claim status and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it is [PII] and it is a direct line with no extension.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 02298999 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Thank you. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The member name is [PII] No. 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 for the claim you'd like me to check on and the total bills?
[CUSTOMER][NEUTRAL] Yes, the date of service is [PII]. And the total bill is $166,387.85.
[AGENT][NEUTRAL] Thank you. So again, that was [PII], and the amount of $166,387.85.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes, correct. And uh and your name is [PII]?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, that's correct. And the first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] You're welcome. Hold on one moment while I get the claim for you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Yes, uh, it is HC Florida Westside Hospital.
[AGENT][NEUTRAL] Alright, so I'm showing received the claim on [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] The claim number is 3557289.
[AGENT][NEUTRAL] And on [PII], the claim was denied, requesting the explanation of benefits from primary insurance.
[AGENT][NEGATIVE] It was been received again on [PII], um, and it was denied for the same reason.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you need that claim information?
[CUSTOMER][NEUTRAL] No, this is an uh recent information, right? You have provided to me?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, sir. Can I get your fax ID number?
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 23. And attention to whom?
[AGENT][NEUTRAL] APL claims department.
[CUSTOMER][NEUTRAL] OK. Uh.
[CUSTOMER][NEUTRAL] Do you need the UV claim form along with the primary UB?
[AGENT][NEUTRAL] Um, yes, you can submit the claim form if you'd like that's up to your preference, but once we receive the um requested documents, we'll go ahead and continue processing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] OK, thank you so much for the information and for the assistance. Can you provide me the call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date.
[CUSTOMER][POSITIVE] OK, [PII]. Thank you so much. Have a wonderful day.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help with?
[CUSTOMER][NEUTRAL] Mm, just give me a moment. Let me check. Is there any other IDs located.
[CUSTOMER][POSITIVE] No, there is no other ID I phone. So that's it. Thanks for asking. Have a wonderful day now.
[AGENT][POSITIVE] Alrighty, well, thanks for calling ATL. You're welcome. You also. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.