AccountId: 011433970860
ContactId: a4e78ca0-af65-4c83-96a2-650a78876ff7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 527710 ms
Total Talk Time (AGENT): 159733 ms
Total Talk Time (CUSTOMER): 220224 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/a4e78ca0-af65-4c83-96a2-650a78876ff7_20250418T18:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Hey, hi, this is [PII] calling from the priority's office to check on the claim status.
[AGENT][NEUTRAL] What's the policy number, [PII]?
[CUSTOMER][NEUTRAL] It's 023359-00. M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Your phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII], and the last name is [PII]. And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information and can you verify the date of service and the total charge?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Date of service is [PII] and the total charge amount was $8,404 even.
[AGENT][NEUTRAL] OK. Is this a professional charge or a facility charge?
[CUSTOMER][NEUTRAL] Facility.
[AGENT][NEUTRAL] A facility charge?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is it [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm not showing a charge for [PII] for 8,404. I show a data service of [PII]. Is it the [PII]?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Sorry, it's [PII].
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the name of the hospital?
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And give me a moment.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh, sorry, you're asking about?
[AGENT][NEUTRAL] What is the name of the hospital?
[CUSTOMER][NEUTRAL] OK. It is HCF Florida Palms West Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Showing the claim received [PII].
[AGENT][NEUTRAL] Uh, claim was processed on [PII], and we are requesting a copy of the major medical explanation of benefits.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Actually, I'll just uh remind you, so we have sent multiple times the primary through fax.
[CUSTOMER][NEUTRAL] And would you please confirm whether you received it or not?
[AGENT][NEUTRAL] OK, verify the fax number the claim was submitted to, please.
[CUSTOMER][NEUTRAL] Sure. Uh just give me a moment.
[AGENT][NEGATIVE] Not received at this time.
[AGENT][NEUTRAL] So let's verify the fax number.
[CUSTOMER][NEUTRAL] Actually, they have sent, uh, give me a moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Mhm, that is the correct fax number. Make that to the attention of claims and are you faxing it or is it, does it go to another area to be faxed to us?
[CUSTOMER][NEUTRAL] No, no, we'll just fax it, so.
[AGENT][NEUTRAL] OK, I'm not showing it received at this time. That is the correct fax number, but also make it to the attention of claims.
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] OK, just give me a moment. I'll just verify once again.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, when did you receive this claim, sorry?
[AGENT][NEUTRAL] The [PII] processed on the [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, the fax number which I have gave is correct, right?
[CUSTOMER][NEUTRAL] And attention to.
[CUSTOMER][NEUTRAL] The games.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And on one call, how many claims you're going to provide?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] On one call, how many claims you're going to provide?
[AGENT][NEUTRAL] Is it for the same person?
[CUSTOMER][NEUTRAL] It's for the different person, more one claim I do have. Shall I pull that claim?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] How many more claims do you have?
[CUSTOMER][NEUTRAL] More one.
[AGENT][NEUTRAL] One more.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what's the policy number?
[CUSTOMER][NEUTRAL] Um, and the caller will be same for the both calls?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Just give me a moment.
[CUSTOMER][NEUTRAL] And just provide me the call reference and I'll just uh go with the other one.
[AGENT][NEUTRAL] OK, let's go ahead and get the date of service and the total charge please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Date of service I do have is
[AGENT][NEUTRAL] I need the policy number first.
[CUSTOMER][NEUTRAL] [PII]? Oh, OK. It is
[AGENT][NEUTRAL] I need the policy number first.
[CUSTOMER][NEUTRAL] Yes, it is 022-03926. M as in Mike, L as in Lima, number 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and the last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you and what's his date of service and the total charge?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Well the amount was 17,306 $56 even.
[AGENT][NEUTRAL] OK. And the name of the hospital?
[CUSTOMER][NEUTRAL] Name of the hospital is HCF Florida University Hospital.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Actually, this is also stating the same thing, need the primary AB.
[AGENT][NEUTRAL] OK, so you've already received the explanation of benefits?
[CUSTOMER][POSITIVE] I'm good.
[AGENT][NEUTRAL] You're correct, we need the primary EOB.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So you already have the information?
[CUSTOMER][NEUTRAL] May I know the
[CUSTOMER][NEUTRAL] Yes, and already we have sent just please uh just once review that.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Whether you received it or not.
[CUSTOMER][NEUTRAL] For
[AGENT][NEUTRAL] Are you saying that the primary explanation was submitted to APL?
[CUSTOMER][NEUTRAL] Yes, we have submitted via mailing address. Sorry, not with the mailing, with the fax.
[AGENT][NEUTRAL] I don't show it.
[AGENT][NEUTRAL] And what mailing address did you?
[AGENT][NEUTRAL] OK, the same fax number that you verified before?
[CUSTOMER][NEUTRAL] No, no, with the faction.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I don't show that we've received it at this time.
[AGENT][NEUTRAL] Make it to the attention of claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure. So, may I get the received and the denied date?
[AGENT][NEUTRAL] Received Feb [PII].
[AGENT][NEUTRAL] And processed on [PII].
[AGENT][NEUTRAL] I'm sorry, those are the wrong dates. Received [PII] and processed [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And just let me know how many uh time you're filing for this in a DSL to submit.
[AGENT][NEUTRAL] There's not a timely filing limit to submit the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So just end up with the call reference number.
[AGENT][NEUTRAL] My name in today's date, [PII].
[AGENT][NEUTRAL] ONYA first initial last name is [PII]. And any other questions?
[CUSTOMER][POSITIVE] No, this is enough for me. Thank you so much for this information. Have a great day ahead, [PII].
[AGENT][POSITIVE] You, you're welcome. Thank you for calling APL. Have a good day as well.
[CUSTOMER][NEUTRAL] Yeah true.