AccountId: 011433970860
ContactId: ad14701d-b6af-46fb-9413-2080094ef1ff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 364510 ms
Total Talk Time (AGENT): 150412 ms
Total Talk Time (CUSTOMER): 130664 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/ad14701d-b6af-46fb-9413-2080094ef1ff_20250228T13:41_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 for the denial reason. Could you please help me with that?
[AGENT][POSITIVE] It would be my pleasure to assist you, [PII], do you mind spelling your name for documentation?
[CUSTOMER][NEUTRAL] Yes, that is [PII].
[AGENT][POSITIVE] Thank you, [PII]. And what is a good callback number, please?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. It's a direct line, no extension.
[AGENT][NEUTRAL] Thank you, [PII]. And do you happen to have that claim number?
[CUSTOMER][NEUTRAL] Um, I don't have claim number, but can I give the date of service and bill amount?
[AGENT][NEUTRAL] That's fine.
[AGENT][NEUTRAL] Yes, let's get the policy pulled up first. What is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Yes, that is 21437.
[AGENT][NEUTRAL] That's gonna be too short for the policy number. Do you have the APL ID card?
[CUSTOMER][NEUTRAL] Uh, let me check, uh.
[AGENT][NEUTRAL] Sounds more like a group number.
[CUSTOMER][NEUTRAL] Yes. Uh, can I say the policy number here I have seen in the EUB that is 022.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 02272854.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. And what is the patient?
[CUSTOMER][NEUTRAL] And I do have claim number too.
[AGENT][NEUTRAL] All right, what's the claim number?
[CUSTOMER][NEUTRAL] 355
[CUSTOMER][NEUTRAL] 4596.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, patient name is uh
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And last name is [PII]. And date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you, [PII], and this is for data service 122 to 123-2024?
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Yes. Yes.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Thank you, [PII]. And what is the provider name, the facility name?
[CUSTOMER][NEUTRAL] It is HCA Florida Kendal Hospital.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] I'm looking at this claim and I'll be happy to help you with that denial reason. It's actually pending for the primary EOB. We are a secondary policy.
[CUSTOMER][NEUTRAL] Yeah, that's what I have.
[CUSTOMER][NEUTRAL] OK. Uh, previously it was sent. Did you receive any mail from us?
[AGENT][NEUTRAL] Not since we received the claim. The claim was received on [PII].
[AGENT][NEUTRAL] Let me check something else. Bear with me.
[CUSTOMER][NEUTRAL] No, I'm asking, uh yeah.
[AGENT][NEUTRAL] Just checking to see if there's any other documents for that data service.
[CUSTOMER][NEUTRAL] No, actually, it is previously faxed the primary UV. I'm asking, did you receive any of EUB from us?
[AGENT][NEUTRAL] No ma'am, we have not received that. Do you know what number that was faxed to?
[CUSTOMER][NEUTRAL] Let me check the information.
[CUSTOMER][NEUTRAL] No, it is sent through the mail. That is [PII].
[CUSTOMER][NEUTRAL] [PII]. OK. [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That is the correct address, but we have not received that as of yet.
[CUSTOMER][NEUTRAL] OK. May I get the claim received date?
[AGENT][NEUTRAL] Now you can fax it.
[AGENT][NEUTRAL] Sure. The claim was received on [PII] and processed on [PII]. Now you can fax that EOB directly to our claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. May I get the fax number?
[AGENT][NEUTRAL] Yes ma'am, the fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK. Can we fax to this?
[AGENT][NEUTRAL] Yes, ma'am, you can fax that EOB directly to our claims department.
[CUSTOMER][NEUTRAL] OK. May I get the claim number once again for the confirmation?
[AGENT][NEUTRAL] Yes, ma'am. The claim number is the one you gave me, the 3554596.
[CUSTOMER][NEUTRAL] Can I get the member ID confirmation?
[AGENT][NEUTRAL] Yes, ma'am. That's 02272854.
[CUSTOMER][POSITIVE] OK. Thank you so much. May I get the call reference?
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] The call reference number is my name and today's date, and I spell my name [PII]. And then it was a pleasure to assist you with that claim status. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No. Thank you so much for your time and assistance. Have a great day.
[AGENT][POSITIVE] And thank you for calling APL and I hope you have a wonderful day as well and a happy weekend.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][NEUTRAL] Bye-bye.