AccountId: 011433970860
ContactId: dacb9407-7f0f-43c8-b24e-0db87e009a63
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 356170 ms
Total Talk Time (AGENT): 94302 ms
Total Talk Time (CUSTOMER): 120150 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/dacb9407-7f0f-43c8-b24e-0db87e009a63_20250519T19:28_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is So[PII]How may I assist you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] My name is Su[PII]I'm calling from provider office to check on a claim status.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] 84[PII]
[CUSTOMER][NEUTRAL] [PII]0[PII]
[CUSTOMER][NEUTRAL] [PII]4[PII]
[AGENT][NEUTRAL] [PII]hank you. What's the name of the facility you're calling from, Miss Su[PII]?
[CUSTOMER][NEUTRAL] Mm, it's here, Florida.
[AGENT][NEUTRAL] I'm sorry, can you repeat that? University Hospital, OK.
[CUSTOMER][NEUTRAL] University Hospital.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] They
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] 16995.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, that sounds like a group number. Do you see a policy certificate number? It's gonna start with a 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] Wait a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEGATIVE] No, I don't find it here.
[AGENT][NEUTRAL] What information do you have from the member to pull up the policy?
[CUSTOMER][NEUTRAL] I need the member's name, date of birth, uh, SSN date of service, bill amount.
[AGENT][NEUTRAL] Do you have a social. OK, let me have the social.
[CUSTOMER][NEUTRAL] OK. The Social Security is 59[PII].
[CUSTOMER][NEUTRAL] 48[PII].
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Member name is Wi[PII].
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Date of birth 7-[PII].
[AGENT][NEUTRAL] OK, thank you. um, what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Date of service, De[PII]o the bill amount.
[CUSTOMER][NEUTRAL] $38,634 even.
[AGENT][NEUTRAL] De[PII]or $38,634.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They
[AGENT][NEUTRAL] Let me see if I can find this claim. For future, you can check claim status online through our website at se[PII]nd that's just optional.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Status
[AGENT][NEUTRAL] OK, it looks like we're needing the primary explanation of benefits to continue the processing of this claim.
[CUSTOMER][NEUTRAL] OK. So, for the confirmation, we have submitted it last on uh 42[PII].
[AGENT][NEUTRAL] How did you send that in?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] We have sent it to the mailing address.
[CUSTOMER][NEUTRAL] 8
[CUSTOMER][NEUTRAL] Mm, wait a moment. The mailing address is?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] PO[PII]This is the appropriate one that we have submitted?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So, you haven't received it?
[AGENT][NEGATIVE] No, we have not received it. Last thing we received was the one that we processed on Fe[PII]which is the one missing, the EOB.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Wait a little moment. What's the family filing?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We don't have family family members.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. The reference number, please?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thanks for providing. Have a nice day. Nice talking to you.
[AGENT][POSITIVE] Mhm. Thank you for calling APR. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah