AccountId: 011433970860
ContactId: dbdec787-a981-4586-bac6-45d40b86ea61
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 615080 ms
Total Talk Time (AGENT): 157057 ms
Total Talk Time (CUSTOMER): 157745 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/dbdec787-a981-4586-bac6-45d40b86ea61_20250128T19:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. This, how may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's billing office to check the claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yes, callback number is [PII] direct line.
[AGENT][NEUTRAL] Thank you. And then what's the patient's name?
[CUSTOMER][NEUTRAL] Patient's name is, I will spell it, it is [PII]
[CUSTOMER][NEUTRAL] [PII] date of, oh sorry, the last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what's the patient's policy number?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] 0197
[CUSTOMER][NEUTRAL] 2375
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, the number 7.
[AGENT][NEUTRAL] Thank you. And then what is the date of service?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[CUSTOMER][NEUTRAL] And the amount is $13,714 even.
[AGENT][NEUTRAL] OK, and then what is the charge amount after the primary paid their part?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Actually, I just have the whole amount.
[AGENT][NEUTRAL] OK, and what is the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Uh, facility name is HCA Florida Kendal Hospital.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, Miss [PII], while I look up this claim for you, and I'll be right back.
[CUSTOMER][NEUTRAL] Yes. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, [PII]. So I did find the claim. The claim number is 347-083-3.
[AGENT][NEUTRAL] The claim was denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] OK. And how can we send through fax or mail?
[AGENT][NEUTRAL] Either way, um, let me give you the fax number, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Or if you want to send it electronically, our payer ID number is 60801.
[AGENT][NEUTRAL] Or if you want to mail it.
[AGENT][NEUTRAL] You can mail it to APL claims.
[AGENT][NEUTRAL] And that is [PII]. That's in [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. And do you need a UB 04 form with the primary UB?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[CUSTOMER][NEUTRAL] And uh uh for this claim, uh, may I know when was the claim received and denied?
[AGENT][POSITIVE] Yes ma'am, let me look that up for you real quick.
[AGENT][NEUTRAL] We received the claim on [PII] and processed the claim on [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And the call reference?
[AGENT][NEUTRAL] You can use my name, it's [PII].
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][POSITIVE] Oh, OK. Thank you. Actually, I have one more claim. Can you assist me with that?
[AGENT][NEUTRAL] Yes, what is the name of the patient?
[CUSTOMER][NEUTRAL] Mm, let me pull up the account. One moment.
[CUSTOMER][NEUTRAL] Uh yes. The patient's name is
[CUSTOMER][NEUTRAL] It's O L G A.
[CUSTOMER][NEUTRAL] The last name is [PII]
[AGENT][NEUTRAL] OK. And what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And her policy number?
[CUSTOMER][NEUTRAL] Policy ID is 000713474.
[AGENT][NEUTRAL] OK, let me pull in her policy.
[AGENT][NEUTRAL] OK, looking at that policy number, I do not see an Olga 4net that has that policy number.
[CUSTOMER][NEUTRAL] Mm, OK. Let me check one more time. One moment.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Um, I just have that one policy ID. It's OK.
[AGENT][NEUTRAL] Let me try to pull her up by her name real quick.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK I think I have her.
[AGENT][NEUTRAL] Um, what is the date of service?
[CUSTOMER][NEUTRAL] Oh yes, the date of service is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] It's $3,099 even.
[AGENT][NEUTRAL] OK, looking at her policy, her policy was not active on [PII]. The policy lapsed on [PII].
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] Yes, [PII], the policy terminated.
[CUSTOMER][NEUTRAL] Oh, OK. And is there any other insurance which is active?
[AGENT][NEUTRAL] No.
[CUSTOMER][POSITIVE] OK. Thank you so much. Just need the, OK. Call reference is same, right? Your name and today's date?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. Thank you so much for that and thank you so much for the assistance.
[AGENT][POSITIVE] You're very welcome. Is there anything else I can help you with?
[AGENT][NEUTRAL] Miss [PII].
[CUSTOMER][NEUTRAL] Uh, no, thank you.
[AGENT][POSITIVE] OK well you have a good day and thank you for calling AP.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEGATIVE] Uh, can you please disconnect the call because my system got stuck.