AccountId: 011433970860
ContactId: f50efb77-b73e-4589-9dd7-9e5ed6235fc1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 281720 ms
Total Talk Time (AGENT): 108157 ms
Total Talk Time (CUSTOMER): 137580 ms
Interruptions: 3
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/f50efb77-b73e-4589-9dd7-9e5ed6235fc1_20250522T13:53_UTC.wav
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[AGENT][NEUTRAL] That morning
[AGENT][NEUTRAL] May I help you?
[CUSTOMER][NEUTRAL] Hello, I'm [PII] last name initial [PII] from the product's office to check up on the claim.
[AGENT][NEUTRAL] OK, I can verify claim status for you and I'm sorry, your name is again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] 02433300. And what's your name?
[AGENT][NEUTRAL] Uh, it's [PII] last initial [PII], and [PII], uh, do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] It's $101 2024 for the total bill of $13,193.25.
[AGENT][NEUTRAL] And do you have the balance after primary?
[CUSTOMER][NEUTRAL] $2,236 even.
[AGENT][NEUTRAL] OK, thank you so much. Give me one moment, please. And while I'm looking up claim information, let you know we do have an online service center where providers can check claim status as well as print out the EOB. That site is at [PII].
[AGENT][NEUTRAL] And what's the name of the provider?
[CUSTOMER][NEUTRAL] Uh, I do not find anything over there.
[AGENT][NEUTRAL] OK, and what is the name of the provider's office?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] SCA Florida Lake City Hospital.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] 2.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 432
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] And I've already called for this one, [PII]. I spoke with [PII] about this.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And they like she stated that
[CUSTOMER][NEUTRAL] Uh, like the primary has already paid for the benefits.
[CUSTOMER][NEUTRAL] Am I right, right, [PII]?
[AGENT][NEUTRAL] Right, benefits are paid in full and part of the explanation of benefits, it does not show the primary applying any amounts towards deductible, co-pay or co-insurance, and that is what we pick up as secondary.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Like, yes, like I have just checked in the EOB for the primary has USC. Uh, it's left for the patient responsibility of $2,236 even.
[AGENT][NEUTRAL] Was that amount applied towards deductible, co-pay, or co-insurance, because on the explanation of benefits we received, it does not show.
[CUSTOMER][NEGATIVE] And there is no payment uh made.
[CUSTOMER][NEUTRAL] Yes, it's
[CUSTOMER][NEUTRAL] It's for
[CUSTOMER][NEUTRAL] Uh, it's, uh, stated for deductible and no payment was made. So that's why I've called again to, to review that, please. Can you just take, uh, can I just see over that?
[AGENT][NEUTRAL] Uh, if you have that EOB where it shows that amount of $2,236 was applied towards the deductible, we would need that EOB because it does not show it on the initial claim we received in the EOB.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, we'll just send the the EOB to you guys, OK? Can you just provide me the fax number?
[AGENT][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] It's 877-365.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] 9423. OK.
[CUSTOMER][NEUTRAL] Just give me 1 2nd.
[CUSTOMER][NEUTRAL] OK. It's [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, so we'll just send or send the UB over that, OK?
[AGENT][NEUTRAL] OK. And is there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, thank you for your assistance, uh, [PII].
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Yeah, you too. Bye.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] OK