AccountId: 011433970860
ContactId: c11788ba-02a5-40b6-9ca2-ad98574fdcc8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 741900 ms
Total Talk Time (AGENT): 169218 ms
Total Talk Time (CUSTOMER): 179724 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/c11788ba-02a5-40b6-9ca2-ad98574fdcc8_20250407T18:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII] calling from provider's office. I have some questions about claim.
[AGENT][NEUTRAL] OK and you said you were calling.
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Sorry, what was that? I didn't listen.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hi [PII], this is [PII] back with you again. You said you were calling about claim status?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] OK, and what's your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Its [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] The name is [PII]. Date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's [PII]'s policy number, please?
[CUSTOMER][NEUTRAL] Is 02521725.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] Is [PII].
[CUSTOMER][POSITIVE] Yeah my niece
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] $399,670 with 25 cents.
[AGENT][NEUTRAL] OK, and then what is the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Sorry, what was that?
[AGENT][NEUTRAL] What is the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Well, the account balance that I have here is $2,638 with 66 cents.
[AGENT][NEUTRAL] OK, thank you and can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yes, it's Grand Strand Medical Center.
[AGENT][NEGATIVE] Put this claim and I will be right back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] [PII].
[CUSTOMER][NEGATIVE] You are on [PII].
[AGENT][NEUTRAL] OK. Thank you for holding for me, [PII]. I'm sorry, [PII]. I've got [PII]'s information pulled up. The
[AGENT][NEUTRAL] Uh, claim number is 3352-888.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim was denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Alright, got it.
[CUSTOMER][NEUTRAL] So what is your fax number to send you the AUB?
[AGENT][NEUTRAL] It is.
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] So it's [PII].
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Alright, got it, um, you only need that just the OB.
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] Are you there?
[AGENT][NEUTRAL] Anything else, is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] Um, yes, another claim, but before that, can I get your reference number please?
[AGENT][POSITIVE] Yes you can use
[CUSTOMER][NEUTRAL] Sorry, I cannot hear you. Um, it's like the call got disconnected or or something, but I'm not hearing you.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, I'm here. Um, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] remind
[CUSTOMER][NEUTRAL] Alright, got it, thank you, let me check the other claim.
[AGENT][NEUTRAL] Yes, and I'll need the member's name, date of birth and policy number.
[CUSTOMER][NEUTRAL] Alright, just a second please.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Alright, the policy number for this one is 02021828 M as Mary L as Lima 7.
[AGENT][NEUTRAL] OK, thank you. And then what is the member's name and date of birth?
[CUSTOMER][NEUTRAL] Um, the name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and then can you please give me the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Yes, it was on [PII]. The amount is $24,063.46.
[AGENT][NEUTRAL] OK, and then what is the charge after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] 1300.
[AGENT][NEUTRAL] OK, and is it for the same facility, Grand Strand?
[CUSTOMER][NEUTRAL] No, it's different it's HCA Florida Hospital.
[AGENT][NEUTRAL] OK. All right. I'm gonna put you on a quick hold. I'm gonna look this up and I'll be right back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, [PII], this is [PII] back with you again. Um, I have the claim pulled up. The claim number is 356-0302, and this claim was also denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][POSITIVE] I like that.
[CUSTOMER][NEUTRAL] Um, OK, can I get the reference number for this one?
[CUSTOMER][NEUTRAL] Hello, can you hear me?
[AGENT][NEUTRAL] Hello, yes, I can hear you.
[CUSTOMER][NEUTRAL] Um, uh, sorry, um, can I get a reference number for this one?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello, I can hear you. Um, that claim was also denied because it needed the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Alright, got it, um, I was asking if I can, I can have the reference number.
[AGENT][NEUTRAL] Oh yes, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] Alright, the same, got it.
[CUSTOMER][POSITIVE] Alright thank you so that was so.
[AGENT][POSITIVE] OK, thank you [PII]. I hope you have a good day. You have a good day too, and thanks for calling APL bye bye.
[CUSTOMER][POSITIVE] Thank you so much for your help. Have a good day.
[CUSTOMER][POSITIVE] Thanks bye bye.