AccountId: 011433970860
ContactId: a07f7430-e71a-4db5-823e-a4c16af7bc2b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275450 ms
Total Talk Time (AGENT): 94851 ms
Total Talk Time (CUSTOMER): 96190 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/a07f7430-e71a-4db5-823e-a4c16af7bc2b_20250207T14:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office to check on the claim status. How are you doing today?
[AGENT][POSITIVE] I'm doing well, [PII]. How are you?
[CUSTOMER][POSITIVE] I'm doing good. Thank you for asking.
[AGENT][NEUTRAL] You're welcome. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Just this one.
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] and it's a direct line.
[AGENT][POSITIVE] Thank you and the policy number whenever you're ready.
[CUSTOMER][NEUTRAL] Yeah, it's 02519291.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, I remember his first name is [PII], last name is [PII], and the date of birth is on [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?
[CUSTOMER][NEUTRAL] Yeah, the date of service is on [PII] and the bill amount is
[CUSTOMER][NEUTRAL] $103,407.39.
[AGENT][NEUTRAL] Thank you for that. And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] It's HCA Florida Mercy Hospital.
[AGENT][NEUTRAL] Thank you. So I'm showing we received the claim on November, I'm sorry, on [PII].
[AGENT][NEUTRAL] The claim number is 3552093.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK, just receive it on.
[AGENT][NEUTRAL] It was received on January.
[CUSTOMER][NEUTRAL] Could you please repeat it again? Receive it.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I do see that the primary you will be sent, uh, has been already sent to you on [PII]. Could you please check it out whether it is received?
[AGENT][NEGATIVE] So we have not received it.
[CUSTOMER][NEUTRAL] On February.
[CUSTOMER][NEUTRAL] They sent on [PII]. Did you receive it yet?
[AGENT][NEGATIVE] It has not been received.
[AGENT][NEUTRAL] You can, however, still fax it, um, mail it or send it electronically and we'll continue processing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just hold on a minute.
[CUSTOMER][NEUTRAL] OK, I see that the uh the UOB is being sent on [PII], so could, could you please, uh, let us, uh, 2 to 3 days to receive the UOB.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] It has been already sent on [PII]. So could you please uh let us allow time to receive the UOB for you.
[AGENT][NEUTRAL] How was it sent?
[CUSTOMER][NEUTRAL] Just hold on a minute. It is sent to.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Male
[AGENT][NEGATIVE] OK, so it has not yet been received. You can either wait for it to be received or you can send it through fax or electronically, but as of today, [PII], it has not been received.
[CUSTOMER][NEUTRAL] It is send through mail.
[CUSTOMER][NEUTRAL] OK. Just give us 4 to 5 days to receive it again. OK. Could you please uh spell your name?
[AGENT][NEUTRAL] My name is [PII] The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK. And could you please provide me the call reference number for today's call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date.
[CUSTOMER][POSITIVE] OK. Thank you for your assistance, [PII]. Have a great day.
[AGENT][POSITIVE] You're welcome [PII]. Was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] No, thank you for your assistance. Have a great day.
[AGENT][POSITIVE] You also thanks for calling [PII]. Bye-bye.