AccountId: 011433970860
ContactId: a9c1012d-f8db-4b0f-a971-989f985d08bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 653030 ms
Total Talk Time (AGENT): 180807 ms
Total Talk Time (CUSTOMER): 145042 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/a9c1012d-f8db-4b0f-a971-989f985d08bc_20250423T17:48_UTC.wav
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[CUSTOMER][NEUTRAL] Me.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You for calling APL.
[AGENT][NEUTRAL] I may help
[CUSTOMER][NEUTRAL] OK. Oh, hi, my name is [PII]. I'm calling from provider's office. I need to check on a claim status.
[AGENT][NEUTRAL] OK uh I can help you with claim status. Can you please give me your callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My callback number is [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] The policy number is 022003942 M as in Mike L as in Lima 7. The name of the patient is [PII], and the date of birth is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let me pull up his policy.
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] OK, let me repeat the policy number you said 022003942.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Sorry, but
[CUSTOMER][NEGATIVE] You are going in and out. I'm unable to hear you properly.
[AGENT][NEUTRAL] OK, so the policy number that you gave to me.
[AGENT][NEUTRAL] Is 022003942 ML 7?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh yes, Mr.
[AGENT][NEGATIVE] OK, that policy is not pulling up for me. It has one too many digits in it.
[AGENT][NEUTRAL] Let me just start with 12.
[AGENT][NEUTRAL] See if that'll work.
[AGENT][NEUTRAL] No, that's not him.
[AGENT][NEUTRAL] Yeah, I'm not able to pull him up with that.
[CUSTOMER][NEUTRAL] Can you check the member's name and date of birth?
[AGENT][NEUTRAL] OK, and you spell it [PII] And how do I spell the last name?
[CUSTOMER][NEUTRAL] Last name is spelled as [PII]
[AGENT][NEUTRAL] OK, let me see if I can find him by the name.
[AGENT][NEUTRAL] OK, and can you tell me what state [PII] lives in?
[CUSTOMER][NEUTRAL] Oh yeah, sure. Just a second.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, do you have social because I do not pull up an [PII] in [PII] on our.
[AGENT][NEUTRAL] Computer.
[CUSTOMER][NEUTRAL] Oh, let me just check the ID card.
[AGENT][POSITIVE] Yes, ma'am. Take your time.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Is anything coming for [PII]?
[AGENT][NEUTRAL] Let me try [PII] instead of [PII].
[CUSTOMER][NEUTRAL] Just [PII], not [PII]. OK. Yeah, sure.
[AGENT][NEUTRAL] Let me try.
[AGENT][NEUTRAL] Yes, I have Netflix.
[AGENT][NEUTRAL] Can you uh verify his, uh,
[CUSTOMER][NEUTRAL] Oh yeah. So actually,
[AGENT][NEUTRAL] Yes, I've got the same [PII] with the same date of birth. OK, and what is the date of service?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So the date of services.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, charge amount?
[CUSTOMER][NEUTRAL] And the bill amount is $377 even.
[AGENT][NEUTRAL] OK, and what are the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] It's $129.78.
[AGENT][NEUTRAL] OK, and what is the name of the facility you're calling from, please?
[CUSTOMER][NEUTRAL] Advent health Orlando.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold.
[CUSTOMER][NEUTRAL] Because
[AGENT][NEUTRAL] And I'm going to look up this claim for you and I'll be right back.
[CUSTOMER][POSITIVE] OK, sure. Take your time.
[AGENT][POSITIVE] Thank
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you Miss [PII] for holding for me. So looking on data service of [PII]. I do not find a claim on file for the amount that you have given me.
[CUSTOMER][NEUTRAL] Can you please check in your, uh,
[CUSTOMER][NEUTRAL] Frontend because uh I do see that it has already been accepted by the clearing house.
[AGENT][NEUTRAL] OK, do you have a claim number?
[CUSTOMER][NEUTRAL] Is there any
[CUSTOMER][NEUTRAL] Uh, no, ma'am. I don't have any claim number. Uh, you can check if there is any rejection in the front end.
[AGENT][NEUTRAL] OK, so looking on data service of [PII], I do not find a claim on file for the amount that you have given me.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] And there is no rejection as well, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. So, uh, may I know your payer ID?
[AGENT][NEUTRAL] Yes, ma'am. It's 60.
[AGENT][NEUTRAL] 1.
[CUSTOMER][NEUTRAL] Sorry, 60
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Let's just check it.
[CUSTOMER][NEUTRAL] And can we submit this claim through uh the mailing address?
[AGENT][NEUTRAL] Yeah, she may do you have that? I can give it to you.
[CUSTOMER][POSITIVE] Uh, yeah, sure. I would like to have that.
[AGENT][NEUTRAL] OK, that is [PII].
[AGENT][NEUTRAL] 950.
[AGENT][NEUTRAL] That's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] And may I know what is the timely filing limit to submit an initial claim.
[AGENT][NEGATIVE] We don't have a timely filing limit.
[CUSTOMER][POSITIVE] OK, then. Thank you so much for all the information. May I know your name?
[AGENT][NEUTRAL] Yes, my name is [PII], it's [PII]
[AGENT][NEUTRAL] And you can use my name and today's date for your reference. The last initial is A.
[CUSTOMER][NEUTRAL] And your last name?
[CUSTOMER][POSITIVE] OK, then thank you so much for all the information. You have a great day ahead.
[AGENT][NEUTRAL] You too, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] Uh, no, thank you.
[AGENT][POSITIVE] OK, well you have a wonderful day and thank you for calling APL. Bye bye ma'am.
[CUSTOMER][NEUTRAL] Bye-bye.