AccountId: 011433970860
ContactId: d2a7ba5a-7073-4f3f-bbe9-7c1164630cf1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 423279 ms
Total Talk Time (AGENT): 178698 ms
Total Talk Time (CUSTOMER): 185385 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/d2a7ba5a-7073-4f3f-bbe9-7c1164630cf1_20250321T14:35_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, very good morning, [PII]. I'm calling from HCF Florida Westside Hospital checking the claim status.
[AGENT][POSITIVE] It would be my pleasure to assist you. May I ask your name?
[CUSTOMER][NEUTRAL] [PII] and last of my name was [PII].
[AGENT][NEUTRAL] [PII], what is a good callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm sorry, do you mind repeating that?
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And [PII], what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Policy number of the patient 0134323 M for Mike, L for Lima 8.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] Patient's first name was [PII] and last name was [PII]. It's first name [PII] Last name [PII] before [PII] And date of birth, [PII].
[AGENT][POSITIVE] Thank you. And then
[AGENT][NEUTRAL] [PII], do you mind repeating that number? It did not come up for that patient, the number.
[AGENT][NEUTRAL] Do you mind repeating it?
[CUSTOMER][NEUTRAL] What I need to repeat policy ID?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] OK. 0134323.
[CUSTOMER][NEUTRAL] Letter M, M for Mike, and L for Lima, and number 8.
[AGENT][NEUTRAL] So
[AGENT][NEGATIVE] OK, so that is not pull it, it's lacking a number. It's missing a number.
[CUSTOMER][NEUTRAL] Yeah, I have claim number. Can you check with the claim number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Absolutely. What is that claim number please, ma'am?
[CUSTOMER][NEUTRAL] Yeah. It's 355-503-3.
[AGENT][NEUTRAL] Perfect. Thank you. I appreciate that. So the policy number is 01343232. It was just missing that one number.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. After 32 ML 8, right?
[AGENT][NEUTRAL] That's right. So it's 01343232.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] Oh, thank you. I appreciate that help with that claim number, [PII], and I can help you with this claim status. Is that for data service 12524?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's December 5th 2024.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And do you mind
[AGENT][NEUTRAL] Verifying the facility name, please.
[CUSTOMER][NEUTRAL] Yes, it's HCA Florida West Side Hospital.
[AGENT][NEUTRAL] All right, thank you, [PII], we did receive that claim on [PII].
[AGENT][NEUTRAL] [PII] and it was processed on [PII]. Mhm.
[CUSTOMER][NEUTRAL] Just a moment, please.
[CUSTOMER][NEUTRAL] Just a moment, please.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Your name, [PII], right?
[AGENT][NEUTRAL] Yes, [PII]
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][NEUTRAL] Yes, go ahead with the claim received it.
[AGENT][NEUTRAL] Claim received date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it's pending for the primary EOB.
[CUSTOMER][NEGATIVE] Denied.
[CUSTOMER][NEUTRAL] OK. Ne primary UB, right? We already submit the claim, primary UB on [PII] at the address of [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]. OK. [PII].
[AGENT][NEUTRAL] Now, actually, that is.
[CUSTOMER][NEUTRAL] And we also send it to the fax.
[AGENT][NEUTRAL] You did send it by fax. Can you verify that fax number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, sure. It's [PII]. So that fax number we send the primary U be on [PII]. Could you please check whether it's received or not?
[AGENT][NEUTRAL] We have not received it yet. Can you re fax it and that does come straight to our claims department or [PII], I can help you with our online portal and you can upload it directly on the policy.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK. To the same fax number I need to send again.
[AGENT][NEUTRAL] You can send it to the same fax number or if you want to go to our portal, I can help you create a login and password and you can upload it online.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. I will try to log in into the portal. Otherwise, if not, I'm not possible to upload in the portal, I will send it to fax.
[AGENT][NEUTRAL] Yes, and the portal address is secured and that's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[AGENT][POSITIVE] [PII] and it's an easy self registration I can assist you.
[AGENT][NEUTRAL] With that
[CUSTOMER][NEUTRAL] Yes, I already uh logged in the portal but uh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you see where it says file a claim option?
[CUSTOMER][NEGATIVE] I'm facing some issue. I will
[CUSTOMER][NEUTRAL] I will, yes, sir. But some issues facing. I will try to send the fax, OK?
[AGENT][POSITIVE] That will be fine. We'll definitely accept it by fax as well.
[CUSTOMER][NEUTRAL] OK, fine.
[CUSTOMER][NEUTRAL] Sure. Can I have the call reference number for this?
[AGENT][NEUTRAL] The call reference number is my name and today's date, and I spell my name [PII].
[AGENT][POSITIVE] And it's been a pleasure to assist you with that claim status, [PII]. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Nothing. Mm, I will send the primary to the fax. Thank you so much for providing information. Have a great day. Bye-bye.
[AGENT][POSITIVE] [PII], thank you for calling APL and I hope you have a wonderful day as well. Take care and happy weekend.
[CUSTOMER][NEUTRAL] Yeah, you too. Bye-bye.
[AGENT][NEUTRAL] Bye bye.