AccountId: 011433970860
ContactId: ea7cade4-9ff2-4c69-82a2-080e014616f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 603619 ms
Total Talk Time (AGENT): 122519 ms
Total Talk Time (CUSTOMER): 163703 ms
Interruptions: 2
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/ea7cade4-9ff2-4c69-82a2-080e014616f3_20250514T18:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah. Hi, sorry. This is uh [PII] calling to the provider's office to check status of if you, uh, to check status of a claim. How are you doing today?
[AGENT][POSITIVE] I'm doing well, [PII]. How are you doing, sir?
[CUSTOMER][POSITIVE] Yeah, I'm doing good. Thank you. TOR
[CUSTOMER][NEUTRAL] E, sorry, [PII]? Oh, I'm sorry. Why?
[AGENT][NEUTRAL] Why?
[AGENT][NEUTRAL] what
[AGENT][NEUTRAL] And [PII], what is your, your call? That's OK. What is your callback number, sir?
[CUSTOMER][POSITIVE] Thank you. I'm sorry for that.
[CUSTOMER][NEUTRAL] The callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then, um, and you're looking for claim status and what is the uh patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, uh sure.
[CUSTOMER][NEUTRAL] Uh, give me one second if you don't mind.
[AGENT][NEUTRAL] No, that's fine.
[CUSTOMER][NEUTRAL] The patient name is [PII].
[CUSTOMER][NEUTRAL] The patient name is uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The member ID is uh
[CUSTOMER][NEUTRAL] 02473288.
[AGENT][NEUTRAL] OK, let me look up [PII]'s policy real quick.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Alright, and then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] Uh, the date of service is, uh, [PII].
[AGENT][NEUTRAL] OK, and then um the charge amount for the data service?
[CUSTOMER][NEUTRAL] Uh, this is $909 even as the charges.
[AGENT][NEUTRAL] OK, and then what are the charges after the primary insurance paid their part?
[CUSTOMER][NEGATIVE] I'm sorry, I didn't get you.
[AGENT][NEUTRAL] Uh, the charge amount after the primary insurance paid their part.
[CUSTOMER][NEUTRAL] Uh, as per here, as I'm checking, uh,
[CUSTOMER][NEUTRAL] [PII] Public Life is showing as a primary.
[AGENT][NEUTRAL] OK, and can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] The facility name is uh Holy Cross Hospital.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, [PII], while I look up this claim for you and I'll be right back, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you, [PII], for holding for me. I have the claim information for you.
[CUSTOMER][NEUTRAL] Uh, one second.
[AGENT][NEUTRAL] The claim
[CUSTOMER][NEUTRAL] Yeah, yeah, sure.
[AGENT][NEUTRAL] The claim number is 351-848-2.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] And the claim has been denied because we need the EOB from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Uh, need primary.
[CUSTOMER][NEUTRAL] EOB from.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The primary insurance, OK. So, who is the primary as per your system? Like, uh, who is the primary?
[AGENT][NEUTRAL] OK, let me look and see if I can find that for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Florida Blue.
[CUSTOMER][NEUTRAL] So, OK.
[CUSTOMER][NEUTRAL] Uh, Florida blue.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. It's a primary, OK.
[CUSTOMER][NEUTRAL] And do you have uh the policy effective date and the term date?
[AGENT][NEUTRAL] Yes, the effective date is [PII] and the policy is still current and active.
[CUSTOMER][NEUTRAL] The current
[CUSTOMER][NEUTRAL] OK. Give me a second if you don't mind.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK. Uh, may I know when the last, uh, coordination of benefits was updated?
[AGENT][NEUTRAL] We do not do coordination of benefits.
[CUSTOMER][NEUTRAL] Like you don't have the updated date when it was updated?
[AGENT][NEGATIVE] We don't we don't do coordination of benefits at all.
[CUSTOMER][NEUTRAL] OK. You don't do coordination of benefits?
[AGENT][NEUTRAL] No, sir.
[CUSTOMER][NEUTRAL] OK. Like you don't have the, uh, when it was updated, right?
[AGENT][NEGATIVE] We, no, we don't do coordination of benefits at all. We don't do it.
[CUSTOMER][POSITIVE] Uh, OK, OK, good.
[AGENT][NEUTRAL] It's based on, it's based on how the policy contract is written.
[CUSTOMER][NEUTRAL] OK. Uh, I will give you the fax number. Could you able to send the uh copy of EOB through fax?
[AGENT][NEUTRAL] Yes, sir. What is your fax number?
[CUSTOMER][NEUTRAL] Yes, I'm giving you the fax number.
[CUSTOMER][NEUTRAL] OK. The fax number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I get that fax ready for you and I'll, I'll be right. Oh, I'm sorry, attention.
[CUSTOMER][NEUTRAL] Attention.
[CUSTOMER][NEUTRAL] Oh, the attention, uh, [PII].
[AGENT][NEUTRAL] Can you spell that for me?
[CUSTOMER][NEUTRAL] [PII]. Yeah, yeah, sure.
[CUSTOMER][NEUTRAL] [PII] [PII] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I get that fax ready for you and I will be right back, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you