AccountId: 011433970860
ContactId: aa692fd3-6557-4936-98ec-42770dd46827
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 482480 ms
Total Talk Time (AGENT): 175608 ms
Total Talk Time (CUSTOMER): 149430 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/aa692fd3-6557-4936-98ec-42770dd46827_20250108T18:57_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII] calling from the provider's office to check on the claim status. How are you doing today?
[AGENT][POSITIVE] I'm doing wonderful, thank you. How about yourself?
[CUSTOMER][POSITIVE] Yes, I'm doing good. Thanks for asking.
[AGENT][POSITIVE] And I'd love to help you with claim status today. Did I hear you correct that your name was [PII]?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] Perfect and do you mind if I get a good call back number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Perfect. And what is the member's policy number that we're looking at today?
[CUSTOMER][NEUTRAL] Yes, uh my ID is 01894924. M as in Mike, L as in Lima, 8.
[AGENT][POSITIVE] Perfect, and give me just a moment to get your member pulled up. One second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright and I do have him pulled up. Would you be able to verify for me please uh your member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, it's just [PII], and the date of birth is [PII].
[AGENT][POSITIVE] Thank you so much and
[AGENT][NEUTRAL] Do you have a claim number that you're wanting further explanation on or are you wanting me to search for it by date of service?
[CUSTOMER][NEUTRAL] D of service?
[AGENT][POSITIVE] Perfect, I'd be happy to do that for you. What's the date of service?
[CUSTOMER][NEUTRAL] Yes, the date of service is [PII].
[AGENT][POSITIVE] Perfect and what was the bill amount?
[CUSTOMER][NEUTRAL] Yes, the amount is $2,689.53.
[AGENT][NEUTRAL] And then the total charge after primary.
[CUSTOMER][NEUTRAL] OK, wait a moment.
[CUSTOMER][NEUTRAL] Yes, the total charges is 29,081 75 cents.
[AGENT][POSITIVE] Wonderful, thank you.
[AGENT][NEUTRAL] All right, give me.
[CUSTOMER][NEUTRAL] I'm logging I'm logging.
[AGENT][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Yeah, I want the first time do I have a kind of Medicare for the one I want.
[CUSTOMER][NEUTRAL] I to.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, I tried, I can't uh.
[AGENT][NEUTRAL] And can you verify for me please the name of the facility charge on this uh or I'm so sorry, the name of the facility on this claim?
[CUSTOMER][NEUTRAL] Yes, the facility name is Holy Cross Hospital, Fort Lauderdale.
[CUSTOMER][NEUTRAL] Lauderdaleen location and I do have the claim number.
[CUSTOMER][POSITIVE] I'm so sorry for that.
[AGENT][NEUTRAL] No worries, is it ending in 863? Is it the same one?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, uh, this is a different one.
[AGENT][NEUTRAL] Oh, OK. What is the claim? Mhm.
[CUSTOMER][NEUTRAL] 352
[CUSTOMER][NEUTRAL] 352-493-8
[AGENT][NEUTRAL] 2948.
[CUSTOMER][NEUTRAL] 352-493-8
[AGENT][NEUTRAL] Alright. 352-493-8.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] Um, thank you. I do see that here. And it looks like.
[AGENT][NEUTRAL] We received that claim on.
[AGENT][NEUTRAL] [PII], we processed the claim on [PII]. I have your claim.
[AGENT][NEUTRAL] Mm I mean you know the claim number, um, and it does look like this claim had benefits payable. It looks like the payable benefits were $2690.44 and if you give me just one moment, I can load the payment details for you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, it looks like they were paid via check. That check number is 2011613, um, and that check was made out to Holy Cross Hospital. It was issued on [PII], and it looks like the check cleared on [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. Uh, is it single check or bulk check?
[AGENT][NEUTRAL] It was a single check.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, when it was issued, that is [PII], right?
[AGENT][NEUTRAL] Uh, no, it was cleared on [PII], but it was issued on [PII].
[CUSTOMER][NEUTRAL] OK. OK. Uh, is there any a patient responsibility for this?
[AGENT][NEGATIVE] Unfortunately, APL cannot determine patient responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Could you please send me a copy of your for this?
[AGENT][POSITIVE] Yeah, I'd love to help send you a copy of that EOB. Hang tight while I pull it up.
[CUSTOMER][NEUTRAL] Trufa.
[CUSTOMER][NEUTRAL] Uh, do you have any payment details on, uh, uh, the, uh, paid amount is 269-044 cents, right?
[AGENT][NEUTRAL] 269-0.44 yep.
[CUSTOMER][NEUTRAL] Uh, uh.
[CUSTOMER][NEUTRAL] We have the information about the allowed amount?
[AGENT][NEUTRAL] No, we're a secondary insurance. we don't have any allowed amounts or anything like that.
[AGENT][NEUTRAL] That's something major medical does.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for that.
[AGENT][POSITIVE] No worries and hang tight while I get that faxed together for you.
[CUSTOMER][NEUTRAL] Uh yes, uh, I need um.
[CUSTOMER][NEUTRAL] You'll be for this one?
[AGENT][NEUTRAL] Yeah, and are you wanting me to make that out that um attention to yourself, [PII], or are you wanting me to make that attention to the patient account number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, uh, actually, I, we, we have received, uh, at, uh, [PII]. Is there any updated EOB or, uh, is it the same?
[AGENT][NEUTRAL] It's the same EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] Could you please send me the uh
[CUSTOMER][NEUTRAL] Call reference number, please, for this call.
[AGENT][NEUTRAL] You bet you. The call reference number is gonna be my name, [PII], first [PII] last name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII]. Thank you for assisting me. Have a great day.
[AGENT][POSITIVE] Hey, it's my pleasure thank you for calling APL you take care.
[CUSTOMER][NEUTRAL] Bye bye.