AccountId: 011433970860
ContactId: ba139cc9-dadf-4264-ad17-81d624db2c49
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 535770 ms
Total Talk Time (AGENT): 152930 ms
Total Talk Time (CUSTOMER): 188890 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/ba139cc9-dadf-4264-ad17-81d624db2c49_20250306T16:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APPL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is uh [PII] calling from provider office regarding claim status.
[AGENT][NEUTRAL] Hi [PII], I can help you with claim status.
[AGENT][NEUTRAL] Can I please get your callback number, sir, just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Sorry, policy number, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Uh, policy number is 024080.
[CUSTOMER][NEUTRAL] Hello? 024080.
[AGENT][NEUTRAL] You, you said there.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Do you see any more numbers because that's, uh, that's not a good policy number.
[CUSTOMER][NEUTRAL] Yeah, I will tell the, the whole number from starting. It said 02408049 M for Mary, L for Lima, 8.
[AGENT][POSITIVE] OK, that's better. Thank you so much.
[CUSTOMER][NEUTRAL] Mhm. Just a moment. Uh, my system, yeah, OK. Good to go.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Now, let me look that policy up.
[CUSTOMER][NEUTRAL] Yeah, yeah. I yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what's the member's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII].
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then can you please give me the date of service and the charge amount for the claim?
[CUSTOMER][NEUTRAL] Yeah, the date of service will be uh
[CUSTOMER][NEUTRAL] [PII] and the charge amount is $5,339.95.
[AGENT][NEUTRAL] Thank you. And then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] I think I don't know. After this, uh, this is the amount showing in my system.
[AGENT][NEUTRAL] OK. And then can you please give me the name of the facility, [PII], that you're calling from?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, the facility, facility is HCF Florida Orange Park Hospital.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look this claim up for you and I will be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, [PII]. So I did find the claim. The number is 353.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 783 7.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was received on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the claim was denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, family insurance. OK, just a moment. Uh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Just a moment, uh, primary. Who is the do you have any primary insurance details? Who is the primary insurance?
[AGENT][NEUTRAL] I don't have that information.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is there anything else I can help you with [PII] before we go?
[CUSTOMER][NEUTRAL] Yeah, I think it's just some information need from you. Uh.
[CUSTOMER][NEUTRAL] Just a second, I'm, uh, checking myself here. Do you have any, uh, fax number or mailing address?
[AGENT][NEUTRAL] Yes sir, the fax number is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Mhm. Yeah, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is in [PII], [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, yeah, yeah, sir.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] The zip code is already done. Uh, I got the zip code. So could you please provide me the fax number is different in my system. So could you please provide the correct fax number? It's uh [PII].
[CUSTOMER][NEGATIVE] After one number is missing.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] 3.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Correct, right? Your voice is breaking, sir. That's why I'm not, uh, uh, take it, uh, so I will uh just confirm this, uh, uh, fax number. It's [PII], right?
[AGENT][NEUTRAL] Yeah, yes.
[CUSTOMER][NEUTRAL] OK. Uh, could you please provide me your uh name and reference number for this call?
[CUSTOMER][NEUTRAL] It's spell.
[AGENT][NEUTRAL] Yes, my name is [PII], it's [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] My last initial is [PII]
[AGENT][NEUTRAL] And you can use my name and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, reference number, right? OK, just a moment. Uh just a moment, please. Yeah, just almost done.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] You need UVG form with the POV, right? Primary UB?
[CUSTOMER][NEUTRAL] Or you need only primary?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] We need the primary EOB to show where they paid their part.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you. Uh thanks for your information.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah. Take care. Bye-bye.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes sir, is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. You have a good day and thanks for calling APL.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.