AccountId: 011433970860
ContactId: bd9b0546-f46e-41e2-84fc-f606bca00886
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 401429 ms
Total Talk Time (AGENT): 110630 ms
Total Talk Time (CUSTOMER): 110244 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/bd9b0546-f46e-41e2-84fc-f606bca00886_20250619T19:22_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, I'm sorry, what was your name again? [PII]?
[AGENT][NEUTRAL] Oh, [PII].
[CUSTOMER][POSITIVE] OK perfect thank you. My name is [PII] and I'm calling uh to follow up on a claim we sent. Would you be able to assist me with that?
[AGENT][NEUTRAL] Sure, Mr. [PII], I can assist you with claim status. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number, Miss?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 02457351
[AGENT][NEUTRAL] Thank you. May I have the name of the facility you're calling from, Mr?
[CUSTOMER][NEUTRAL] I'm calling from Shans at the University of Florida.
[AGENT][NEUTRAL] OK, thank you. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] and the amount of $1,195.
[AGENT][NEUTRAL] All right. OK, thank you. Let me see if I can find this claim and for future, you can check claim status online through our website at [PII] and that's just optional. Um.
[CUSTOMER][NEUTRAL] Wait, what is that secure what?
[AGENT][NEUTRAL] Secured. [PII].
[CUSTOMER][NEUTRAL] And [PII].
[CUSTOMER][POSITIVE] [PII]. OK perfect.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and bear with me let me pull this ELB for you.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so it looks like we processed the claim on [PII]. The claim was denied. I'm waiting for the denial reason to come up, OK?
[AGENT][NEUTRAL] OK, so it looks like it was denied stating the benefits are payable only if major medical insurance provides benefits.
[CUSTOMER][NEUTRAL] So is that in other words for other insurances primary?
[AGENT][NEUTRAL] Yes, um, we're not the primary, we're the secondary.
[CUSTOMER][NEUTRAL] OK, other insurance.
[CUSTOMER][NEUTRAL] OK, do you happen to have a claim number for this?
[AGENT][NEUTRAL] Sure, yes. The claim number is 3610063.
[CUSTOMER][NEUTRAL] And can you fax me a EOB please?
[AGENT][NEUTRAL] Mm sure.
[AGENT][NEUTRAL] OK, what is the fax number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is going to be [PII].
[CUSTOMER][NEUTRAL] 819
[CUSTOMER][NEUTRAL] 4983 and if you could put attention [PII].
[AGENT][NEUTRAL] How do you spell that?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And that's [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. Do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][POSITIVE] Sure, absolutely, thank you so.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for you, Mrs. OK, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Perfect, can I receive a reference number for this phone call, please?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] OK, well, I appreciate your help. Thank you for your assistance.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] You're welcome and thank you for calling ATL. Have a good afternoon, Mr.
[CUSTOMER][NEUTRAL] Yeah I think the conversation.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Actually said she's sending it to me now. Let's see if I actually.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEGATIVE] You are on hold.