AccountId: 011433970860
ContactId: dbbf42e9-74e2-4b5e-9aab-f764dbdc2d58
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 245949 ms
Total Talk Time (AGENT): 94588 ms
Total Talk Time (CUSTOMER): 66761 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/dbbf42e9-74e2-4b5e-9aab-f764dbdc2d58_20250203T21:48_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. My last initial is [PII] [PII]. Call on behalf of provider's office to check the claim status.
[AGENT][POSITIVE] OK. I'll be more than happy to help you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] 1
[AGENT][NEUTRAL] Alright, and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 022
[CUSTOMER][NEUTRAL] 6050
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] M for Mike, L for Leo, number 7.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] My first name is [PII] and the last name is [PII] and the date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you like me to check on?
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII].
[CUSTOMER][NEUTRAL] With the charge amount of $3,0008.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Sheridan Health crop INC.
[AGENT][NEUTRAL] All right, so I'm showing that the claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 345. I'm sorry.
[AGENT][NEUTRAL] 354.
[AGENT][NEUTRAL] 8480.
[CUSTOMER][NEUTRAL] That's
[AGENT][NEUTRAL] In January, and on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] Uh, what is the primary insurance, uh, listed in our system?
[AGENT][NEUTRAL] I'm showing Blue Cross Blue Shield of Florida.
[CUSTOMER][NEUTRAL] Will it be 1 2nd.
[CUSTOMER][NEUTRAL] Is it active on the data service?
[AGENT][NEUTRAL] Um, hold on one moment.
[AGENT][NEUTRAL] Yes, this policy has been active since [PII].
[CUSTOMER][NEUTRAL] Yeah, can you please confirm the member ID BCBS member ID?
[AGENT][NEUTRAL] 226-0508
[CUSTOMER][NEUTRAL] Uh, I'm asking the member ID.
[AGENT][NEUTRAL] OK, so we don't have member IDs. All we have is the APL policy number. What, what is it that you're trying to figure out for the claim?
[CUSTOMER][NEUTRAL] Uh, for the BCBS uh, if I have the member ID, I will, uh, check, I will check and I will uh send the claim to the BCBS.
[AGENT][NEUTRAL] The member ID for for primary insurance?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh, we don't have primary's information. That's a different insurance company. We only show their name.
[CUSTOMER][NEUTRAL] Sure, OK. Got it. Can I get the call reference number, [PII]?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date and again the first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Yeah, got it, [PII]. I think that's it from my end.
[AGENT][POSITIVE] Alrighty, well, thank you.
[CUSTOMER][POSITIVE] Thank you for assisting me.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a great day.