AccountId: 011433970860
ContactId: c220d087-711f-459b-b173-1e81ec6d40ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 368709 ms
Total Talk Time (AGENT): 177800 ms
Total Talk Time (CUSTOMER): 90630 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/c220d087-711f-459b-b173-1e81ec6d40ab_20250203T17:01_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider office to check on a claim status. How are you doing today?
[AGENT][NEUTRAL] I'm doing good, but I am so sorry I did not catch your name, please sir.
[CUSTOMER][NEUTRAL] Yeah, my name is [PII].
[AGENT][NEUTRAL] OK, [PII], thank you for that. Go ahead and give me a good policy number, please, sir.
[CUSTOMER][NEUTRAL] Sure, the policy number is 0241.
[CUSTOMER][NEUTRAL] 342 9 M as in Marco, L as in Lima, 7.
[AGENT][POSITIVE] Alrighty, thank you so much for that information, [PII]. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please, sir.
[CUSTOMER][NEUTRAL] That's [PII]. It's a direct call, no extension needed.
[AGENT][POSITIVE] Alrighty [PII], thank you so much for all that information. Now, what is your patient's name and date of birth today, please, sir?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sure. The patient name is
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Alrighty, thank you so much for all that information. [PII] looks like [PII] is a dependent on this medical supplemental plan, and you did say you want to check status of a claim. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] The date of service is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your total bill, please, sir. Mhm.
[CUSTOMER][NEUTRAL] And the total uh
[CUSTOMER][NEUTRAL] Yeah, that's 7,838.
[CUSTOMER][NEUTRAL] Dollar even.
[AGENT][NEUTRAL] And what's the name of the provider?
[CUSTOMER][NEUTRAL] Yeah, that's from HCA Florida Poms West Hospital.
[AGENT][NEUTRAL] Alrighty [PII], thank you so much for all that information. It looks like I do have that ER hospital bill in for that amount, and what we are needing is the uh primary insurance company's explanation of benefits as we are just the medical supplemental plan.
[AGENT][NEUTRAL] So once we receive that EOB, yes, sir, we will coordinate any benefit that that is available.
[CUSTOMER][POSITIVE] OK, thanks so
[CUSTOMER][NEUTRAL] OK, thanks for that. Uh, could you please tell me your name?
[AGENT][NEUTRAL] Yes, my name is [PII]. That is spelled [PII].
[AGENT][NEUTRAL] [PII] yes. And is that all that I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] OK. Thanks for that. Uh, could you please provide me the fax number attention to send the primary OB?
[AGENT][NEUTRAL] Yes, but make sure you send a copy of the bill along with that primary EOB. You have to send those together and you can fax those over as long as they're legible at fax number one.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 877.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And put attention claims department.
[CUSTOMER][NEUTRAL] Uh, could you please provide me the mailing address?
[AGENT][NEUTRAL] Yes, our mailing address is to APL Claims Department [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] We're in [PII].
[AGENT][NEUTRAL] Zip [PII].
[CUSTOMER][NEUTRAL] And the ZIP code is [PII], am I right?
[AGENT][NEUTRAL] [PII]. That is correct, [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, thanks for that. Uh, could you please provide me the time limit?
[AGENT][NEUTRAL] We do not have a timely filing limit, so you are good to file that at any time, [PII].
[CUSTOMER][NEUTRAL] OK. Could you please provide me the uh plan type?
[AGENT][NEUTRAL] This is a medical supplemental plan.
[CUSTOMER][NEUTRAL] Could you please provide me the effective one term date?
[AGENT][NEUTRAL] Effective date is [PII] and it is still active.
[CUSTOMER][NEUTRAL] Uh, could you please tell me the group name?
[CUSTOMER][NEUTRAL] And group number?
[AGENT][NEUTRAL] Let's see, yes, let's see.
[AGENT][NEUTRAL] Group number 19145.
[AGENT][NEUTRAL] Group name is Faherita Group of America.
[AGENT][NEUTRAL] And is there anything else I can answer for you?
[CUSTOMER][NEUTRAL] OK. Uh, could you please, uh,
[CUSTOMER][NEUTRAL] Yeah, could you please provide me the call reference number for this call?
[AGENT][NEUTRAL] We do not give call reference numbers [PII], but you can use my name in today's date if you need to do so, OK?
[CUSTOMER][POSITIVE] Yeah, OK. Thanks for that. Thanks for your assistance. Have a great day.
[AGENT][POSITIVE] You as well, [PII], and thanks for calling APL. Bye-bye.