AccountId: 011433970860
ContactId: 9fa6009b-9b9d-4759-bf18-825c68522da0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 578140 ms
Total Talk Time (AGENT): 204255 ms
Total Talk Time (CUSTOMER): 164031 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/9fa6009b-9b9d-4759-bf18-825c68522da0_20250327T21:29_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling on behalf of the provider's office to check on a claim service.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status, Mr. [PII]. And may I have
[AGENT][NEUTRAL] A callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure. The callback number would be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And would you're calling from which uh facility for my attention?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What is the name of the facility?
[CUSTOMER][NEUTRAL] Facility's name is Florida, Northwest Hospital.
[AGENT][NEUTRAL] OK, you said Florida and what's the next name hospital?
[CUSTOMER][NEUTRAL] Could I get you?
[AGENT][NEUTRAL] What's the name of the facility?
[CUSTOMER][NEUTRAL] The facility's name is Hea Florida Northwest Hospital.
[AGENT][NEUTRAL] OK, the only thing I'm getting is hospital. OK. Um, what is the patient's policy number?
[CUSTOMER][NEUTRAL] Patient's policy number would be 0 as in Oscar 167291.
[CUSTOMER][NEUTRAL] 2 M as in Mike, L as in Lima, 7.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] The member's name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Could I get you?
[AGENT][NEUTRAL] The date of service and the amount of the claim.
[CUSTOMER][NEUTRAL] Oh, data service was on [PII].
[CUSTOMER][NEUTRAL] And the amount would be 44,000.
[CUSTOMER][NEUTRAL] Uh, so the amount is $44007.
[AGENT][NEUTRAL] OK, and you said the date of service, can you repeat that date of service one more time?
[CUSTOMER][NEUTRAL] It is on [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, let me see if I can find this claim for future. You can check claim status online through our website at [PII], and that's just optional.
[AGENT][NEUTRAL] And bear with me.
[AGENT][NEUTRAL] OK, you said the total charge was $44,0007 even?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. Um, we have not received that claim as of today.
[CUSTOMER][NEUTRAL] Oh, OK, just give me a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'll just check where it has been.
[CUSTOMER][NEUTRAL] Submitted, it has been submitted to paper on [PII].
[CUSTOMER][NEUTRAL] 20.
[CUSTOMER][NEUTRAL] 2025. Just a second, what would be the mailing address?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Is the PO is your mailing address [PII]?
[CUSTOMER][NEUTRAL] And uh the state, I guess it is yeah Miss [PII], I guess.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], no, that's that's the incorrect address.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. May I have the payer ID?
[AGENT][NEUTRAL] Um, yeah, let me give you the payer ID and the correct address. Do you have an incorrect address.
[CUSTOMER][NEUTRAL] Sure, sir. Please help me with that.
[AGENT][NEUTRAL] Now this kind, OK.
[AGENT][NEUTRAL] Mm, sure.
[AGENT][NEUTRAL] Let me know when you're ready for the information.
[CUSTOMER][POSITIVE] Sure, sure. Please do help me with that.
[AGENT][NEUTRAL] I'm sorry, you said to give you a minute?
[CUSTOMER][POSITIVE] No, no, you can help me with that. I'm ready as of now.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] All right. Um, well, this one is a secondary supplemental plan to the major medical. So we need this uh claim either fax or mail. Um, I can give you the payer ID, but it's just for your records, OK? Because the claim needs to be either fax or mail.
[CUSTOMER][NEUTRAL] Oh, sure, sir.
[AGENT][NEUTRAL] OK, so the payer ID is 60801. Again, that's 60801.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] The mailing address is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh what would be the fax number to send?
[AGENT][NEUTRAL] Yes, sure. [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. And uh what would be a timely finding limit?
[AGENT][NEGATIVE] We don't have timely filing limits.
[CUSTOMER][NEUTRAL] OK. And what would be uh the member's group number? Do you have any specific group number?
[AGENT][NEUTRAL] Um, let me see, one moment. Let me get that.
[AGENT][NEUTRAL] The group number is 18766.
[CUSTOMER][NEUTRAL] OK. And uh may I have the member's plan type? Is it PPO, HMO or APO?
[AGENT][NEUTRAL] No, this is a secondary supplemental plan to the major medical.
[AGENT][NEUTRAL] Which is commercial.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh uh may I have the member's plan effective date?
[AGENT][NEUTRAL] Yes. The effective date is [PII] and it is um terminated on [PII].
[CUSTOMER][NEUTRAL] OK, and uh.
[CUSTOMER][NEUTRAL] Uh, so you pay, uh,
[CUSTOMER][NEUTRAL] What would be the payer name for this one? Uh, it is Medicare Secondary Supplement Plan.
[AGENT][NEUTRAL] No, no, no. This is APL American Public Life. This is a secondary supplemental plan to the major medical, to any major medical, not Medicare.
[CUSTOMER][NEUTRAL] OK. Uh, so just to confirm, the member ID is 01672912ML7, right?
[AGENT][NEUTRAL] That is the incorrect number. Let me give you the correct number.
[CUSTOMER][NEUTRAL] Sure, please send me that.
[AGENT][NEUTRAL] The number is 0185.
[AGENT][NEUTRAL] 2046.
[CUSTOMER][NEUTRAL] OK. So the member ID is 01852046, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And there's just numbers, there's no letters, right?
[AGENT][NEUTRAL] I'm sorry, can you repeat?
[CUSTOMER][NEUTRAL] I mean, there's no letters, right? It's just numbers, right?
[AGENT][NEUTRAL] You don't need those letters, um, that's just to let us know what product is it that it's not required.
[CUSTOMER][POSITIVE] OK, OK. Got it. OK. Uh, thanks so much for your time. I really appreciate it. May I have your call reference number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] OK. Uh, I didn't get any. Could you please help me with that?
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. Last [PII] is [PII].
[CUSTOMER][POSITIVE] OK, sir. Thanks for your time. Have a great and good day. Bye-bye.
[AGENT][POSITIVE] You're welcome. You as well, and thank you for calling APL. Goodbye.
[AGENT][NEUTRAL] Mm