AccountId: 011433970860
ContactId: e1c9c02b-585b-4bfc-990a-a6cd15bf4f4f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1651530 ms
Total Talk Time (AGENT): 408747 ms
Total Talk Time (CUSTOMER): 465835 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/e1c9c02b-585b-4bfc-990a-a6cd15bf4f4f_20250117T15:53_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] calling from provider office checking on claim status.
[AGENT][NEUTRAL] OK, yeah, I could check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. It's [PII].
[AGENT][POSITIVE] OK thank you and can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah. It's [PII].
[AGENT][NEUTRAL] All right, thank you. And then did you have the policy number?
[CUSTOMER][NEUTRAL] Yeah. It's 02478718. M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] All right, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Did you have the date of birth?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that and uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] And that was [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and uh the bill amount please.
[CUSTOMER][NEUTRAL] Yeah, it's $4380 even.
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Was that amount uh before or after major medical paid?
[CUSTOMER][NEUTRAL] Yeah. The primary insurance transfer of the $500 to the secondary insurance.
[AGENT][NEUTRAL] 500, OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what was the provider that you're with? I'm sorry.
[CUSTOMER][NEUTRAL] Yeah, it's Holy Cross Hospital, Fort Lauderdale parent location.
[AGENT][NEUTRAL] Got it. OK, do you believe I found this claim.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Yes, OK, so we did pay a benefit of $211.01 and that met their maximum.
[CUSTOMER][NEUTRAL] It's benefits. Could you please repeat?
[AGENT][NEUTRAL] Yes, uh, so we paid a benefit of $211.01 and that met their maximum for the date of service.
[AGENT][POSITIVE] Maximum benefit amount.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you need that claim number?
[CUSTOMER][NEUTRAL] Yeah, yeah, I want.
[AGENT][NEUTRAL] OK, let me know when you're ready.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It is 352-924-0.
[CUSTOMER][NEUTRAL] May I know the received date and processed date?
[AGENT][NEUTRAL] Yes, one moment.
[AGENT][NEUTRAL] So that uh claim was received [PII].
[AGENT][NEUTRAL] And it was processed [PII].
[CUSTOMER][NEUTRAL] OK, OK, just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, you said $211.01 is the maximum benefits to pay, right?
[AGENT][POSITIVE] For the data service, yeah, that, that met their maximum.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] May I know the check number?
[AGENT][NEUTRAL] Yeah, check number is 2013436.
[CUSTOMER][NEUTRAL] 36. And it is a single checker as paper check or bulk check?
[AGENT][NEUTRAL] That is a single check.
[CUSTOMER][NEUTRAL] The single. OK. May I know the issue, issue date? Check date.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, check was issued. Yes, uh, it was issued November, [PII].
[AGENT][NEUTRAL] And I am showing that the the check did clear [PII].
[CUSTOMER][NEUTRAL] No [PII], yeah.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, could you please update the will to the next?
[AGENT][NEUTRAL] Yeah, I can send you the EOB. uh, what was the fax number for you?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that back, make sure I heard that correctly. That was [PII]?
[CUSTOMER][POSITIVE] Yeah, it's correct.
[AGENT][NEUTRAL] OK, and when I just put this to your attention?
[CUSTOMER][NEGATIVE] Oh, no, there is no attention.
[AGENT][NEUTRAL] No attention?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, alright, I will get that sent to you. You should get it here in about um 10-15 minutes depending on how busy your machine is. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Yeah, may I know the call reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial and today's date, uh, so my.
[CUSTOMER][NEUTRAL] Yeah. Could you please spell your name, one, sorry?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, that's OK. So my name is spelled [PII]
[CUSTOMER][NEUTRAL] It's, could you please repeat?
[AGENT][NEUTRAL] Yeah, so [PII].
[AGENT][NEUTRAL] And then my last initial is [PII].
[CUSTOMER][NEUTRAL] Yeah, how much time it will take, it will be to update?
[AGENT][NEUTRAL] Uh, probably about 10-15 minutes depending on how busy your machine is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, [PII]. I have another account. Could you please help me there?
[AGENT][NEUTRAL] I'm sorry, could you repeat that?
[CUSTOMER][NEUTRAL] Yeah, I have another patient. Could you please help me that claim.
[AGENT][NEUTRAL] Oh yeah I can another claim yeah give me just a moment. I'm gonna go ahead and send this EOB. I'll let you know when I'm ready.
[CUSTOMER][POSITIVE] OK. OK. Take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, I am ready for that next policy number.
[CUSTOMER][NEUTRAL] Yeah, just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah. It's 01894924. M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] OK and then uh what was the name and date of birth for this insured?
[CUSTOMER][NEUTRAL] Yeah, it's [PII], it's [PII]
[AGENT][NEUTRAL] Alright, thank you for that and uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Oh thank you for that. Yes, what what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK, and the uh billed amount, please?
[CUSTOMER][NEUTRAL] Yeah, it's $29,81.75.
[AGENT][NEUTRAL] 25. OK, thank you one moment.
[AGENT][NEUTRAL] And what was the amount uh after major medical paid?
[CUSTOMER][NEUTRAL] Yeah, it's one of the $5,379.97.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I did find this claim, uh, we paid a benefit of $2690.44 and that met their calendar year maximum.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the claim number?
[AGENT][NEUTRAL] Claim number is 352-493-8.
[CUSTOMER][NEUTRAL] Yeah, you can put it up.
[CUSTOMER][NEUTRAL] You know and uh.
[CUSTOMER][NEUTRAL] Yeah, where are the 6 number.
[AGENT][NEUTRAL] I'm sorry, could you repeat that?
[CUSTOMER][NEUTRAL] Yeah, the maximum benefit amount is $2690.47 is right.
[AGENT][POSITIVE] That met their maximum for the calendar year, yes.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have to check, check number.
[AGENT][NEUTRAL] Yeah, check number is 2011613.
[CUSTOMER][NEUTRAL] Is it single check or bulk?
[AGENT][NEUTRAL] No, it's a single track.
[CUSTOMER][NEUTRAL] Yeah, may I know the issue date?
[AGENT][NEUTRAL] Yes, the check was issued [PII].
[AGENT][NEUTRAL] And I am showing it did clear [PII].
[CUSTOMER][NEUTRAL] Uh, but uh.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And uh yeah. Could you please update the EOB through the fax?
[AGENT][NEUTRAL] Of course give me just a moment.
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] The same fax number.
[AGENT][POSITIVE] Yes ma'am. OK. I will go ahead and get that sent to you as well.
[CUSTOMER][NEUTRAL] I pick up before [PII] only yeah.
[CUSTOMER][NEUTRAL] For you.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Hey.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] $15.
[CUSTOMER][NEUTRAL] Who you that.
[CUSTOMER][NEUTRAL] Let me hit go.
[AGENT][NEUTRAL] OK, I just sent that other one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I have. Could you please help me there 25.
[AGENT][NEUTRAL] Was there anything else I can help you with?
[AGENT][NEUTRAL] I'm sorry, could you repeat that?
[CUSTOMER][NEUTRAL] Uh, I have another client, another patient. Could you please help me?
[AGENT][POSITIVE] We have another one yeah one moment I'll let you know when I'm ready.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] If you can
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Get it.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And I.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] OK. I'm ready for that next policy number.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm sorry, your audio is kind of cutting out.
[CUSTOMER][NEUTRAL] OK, yeah. Can I repeat again?
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um, what was the policy number?
[CUSTOMER][NEUTRAL] Yeah, my phone number [PII].
[AGENT][NEUTRAL] I apologize, the audio cut out at the beginning. Could you please repeat that?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Got it. Thank you. Uh, what was the name and date of birth for this insured?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] [PII]. It's [PII]
[AGENT][NEUTRAL] OK, and then uh the date of birth, please?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, it's right. [PII].
[AGENT][NEUTRAL] OK and then um.
[AGENT][NEUTRAL] Thank you. What was the bill amount?
[CUSTOMER][NEUTRAL] Yeah, it's $1,149 even.
[CUSTOMER][NEUTRAL] And the transfer of amount is.
[AGENT][NEUTRAL] That was 1100 and oh go ahead go ahead.
[CUSTOMER][NEUTRAL] 14, yeah, it's $275 to bill to the secondary insurance. Yeah, right.
[AGENT][NEUTRAL] 275.
[AGENT][POSITIVE] Got it OK thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I did find this claim, uh, looks like we paid that full benefit amount uh 275 even.
[CUSTOMER][NEUTRAL] Yeah, I mean I still date and process the date.
[AGENT][NEUTRAL] Yes, give me just a moment.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] So we received this claim [PII] then it was processed [PII].
[CUSTOMER][NEUTRAL] Yeah, the amount is $275 even that right it's benefitary amount.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah, may I take number?
[AGENT][NEUTRAL] Check number is 1869166.
[CUSTOMER][NEUTRAL] Yeah, may I know the, it is single check boxing?
[AGENT][NEUTRAL] It is a single check.
[CUSTOMER][NEUTRAL] Yeah, I, is your dog?
[AGENT][NEUTRAL] Uh, the issue date was [PII], and I am showing that this check has not cleared, so I can get this one, reissued to you. Um, I'll confirm the address. Let me know when you're ready.
[CUSTOMER][NEUTRAL] Yeah,
[AGENT][NEUTRAL] OK, I've got the address as [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, could you please spell, spell that?
[AGENT][NEUTRAL] Of the city, [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] The address for what where we sent the check.
[CUSTOMER][NEUTRAL] Yeah, it's [PII] after that.
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] Yeah, just a moment, I will.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah, it's correct. It's [PII]. Is it right?
[AGENT][NEUTRAL] Yes, yes, that's what we've got. OK, so I will go ahead and get that this check voided and reissued to you.
[CUSTOMER][NEUTRAL] Yeah. May I know the reason why this is the issue?
[AGENT][NEUTRAL] Um, I'm just showing that the check has not cleared, um, so I don't know if y'all just didn't receive it or something like that, but I will get it, uh, reissued to you.
[CUSTOMER][NEUTRAL] OK just a moment.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah, yeah, I'm here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, yeah, this check is cash.
[CUSTOMER][NEUTRAL] Or not
[AGENT][NEUTRAL] It was, it was cashed.
[CUSTOMER][NEUTRAL] It was
[CUSTOMER][NEUTRAL] Yeah, which date? It was cash.
[AGENT][NEUTRAL] It was OK, so I don't need to reissue this check?
[CUSTOMER][NEUTRAL] Yeah, you told it was cash. Which day? It's [PII], right?
[AGENT][NEUTRAL] I'm sorry, I wanna make sure I understand you're saying that this check was cashed?
[CUSTOMER][NEUTRAL] Yeah, cash or not?
[AGENT][NEUTRAL] It was
[AGENT][NEUTRAL] No, I'm showing that it has not.
[AGENT][POSITIVE] That's why I'm going to reissue it to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah. Thank you. May the call reference number?
[AGENT][NEUTRAL] Yeah, reference number would just be my first name, last initial, and today's date.
[CUSTOMER][NEUTRAL] Yeah. Yeah, [PII], I have another account. Could you please help me there?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] It, I did not receive any UOB. Could you please fax through the UOB?
[AGENT][NEUTRAL] The EOB for this claim?
[CUSTOMER][POSITIVE] Yeah, it is clear.
[AGENT][NEUTRAL] Yeah, give me just a moment I'll get that sent to you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I just sent this other one to you.
[CUSTOMER][NEUTRAL] Yeah, can I have one question?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, just a moment.
[CUSTOMER][NEUTRAL] Yeah, could you please tell me the check track ID?
[AGENT][NEUTRAL] The check what I'm sorry.
[CUSTOMER][NEUTRAL] Stack racing.
[CUSTOMER][NEUTRAL] Number or any.
[AGENT][NEUTRAL] The number?
[CUSTOMER][NEUTRAL] Oh, is it. Yes, sir.
[CUSTOMER][NEUTRAL] Yeah, I asked track ID number.
[AGENT][NEUTRAL] Our payer ID?
[CUSTOMER][NEUTRAL] Yeah, check track ID.
[AGENT][NEUTRAL] Yeah, our payer ID
[AGENT][NEUTRAL] Our payer ID is 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Could you please help me another claim?
[AGENT][NEUTRAL] Did you say there was another claim?
[CUSTOMER][NEUTRAL] Yeah, in the
[AGENT][NEUTRAL] Yeah, give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, you can go ahead and give me that next policy number actually.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Can I say?
[CUSTOMER][NEUTRAL] It's 1330836. M as in Mike, L as in Lima, 8.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Are you there? Hello?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Can
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Um