AccountId: 011433970860
ContactId: c1f7fc7f-2468-42e1-ba52-f09f04cc5c13
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 420220 ms
Total Talk Time (AGENT): 77738 ms
Total Talk Time (CUSTOMER): 145137 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/c1f7fc7f-2468-42e1-ba52-f09f04cc5c13_20250410T19:18_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hi, this is [PII] and I'm calling for Florida Women Care to check on additional information about a claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes. I have already checked your portal. Can you please spell your first name?
[AGENT][NEUTRAL] My first name is [PII]. It's [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Got it, yeah. Thank you.
[AGENT][NEUTRAL] OK, and your name is [PII]?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[AGENT][NEUTRAL] OK. And your uh callback number?
[CUSTOMER][NEUTRAL] [PII]. There is no extension. It is a direct line.
[AGENT][NEUTRAL] OK, thank you. And the policy number of the patient.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Policy number of the patient is
[CUSTOMER][NEUTRAL] 01891562 M as in Mike, L as in Lima 8.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Patience, first name is [PII]. Last name I will spell [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] What was that date of service or claim number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Date of service is [PII].
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and the build out?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] The amount is
[CUSTOMER][NEUTRAL] $5.36.
[AGENT][NEUTRAL] Um, I have a claim for that date, but not for that bill amount.
[AGENT][NEUTRAL] And a claim for $18.
[CUSTOMER][NEUTRAL] I want to claim for that date.
[AGENT][NEUTRAL] Yeah, I have a I have a claim for that date for $18.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, you're right. Sorry for that.
[AGENT][NEUTRAL] OK, looks like, let's see.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Uh, that claim was received [PII]. Process [PII].
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, it says incomplete claim information.
[AGENT][NEUTRAL] Information receipt but could not be processed need additional information.
[CUSTOMER][NEUTRAL] So what, what information is required?
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Give me one moment, pulling that up.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] OK, um, I'm not sure. I can't tell what's required because I see that you submitted the primary explanation of benefits, so.
[AGENT][NEGATIVE] I've got a charge for $18 down here.
[AGENT][NEUTRAL] So I'll send this back through for processing.
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] OK, just bear with me a moment. Yes, just bear with me I'm noting down this information.
[CUSTOMER][NEUTRAL] OK, you're sending the claim back for the process.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] like
[CUSTOMER][NEUTRAL] Are you sending this claim back for the process?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] To a.
[CUSTOMER][NEUTRAL] I I
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The.
[CUSTOMER][NEUTRAL] so much.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] what
[AGENT][NEUTRAL] Do you need any other information?
[CUSTOMER][NEUTRAL] No, what about the turnaround time for this?
[AGENT][NEUTRAL] It takes about 7 to 10 working days.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just bear with me for a moment.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Can you please provide me the reference number for this number?
[AGENT][NEUTRAL] Uh it's just my name, [PII], and today's date.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK, thank you. Have a great day.
[AGENT][POSITIVE] Thank you for calling APL you as well.
[CUSTOMER][NEUTRAL] Yeah