AccountId: 011433970860
ContactId: f88dbd23-b362-4741-8817-21fbbaeea2f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 751599 ms
Total Talk Time (AGENT): 190498 ms
Total Talk Time (CUSTOMER): 280596 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/f88dbd23-b362-4741-8817-21fbbaeea2f5_20250425T14:30_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[AGENT][POSITIVE] Good morning. Thank you for calling.
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling from.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, good morning. My name is [PII]. I'm calling from provider office to check the claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status. May I have the name of the provider you're calling from?
[CUSTOMER][NEUTRAL] Is she a Florida Medicine Hospital?
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected Miss [PII]?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] The policy number is um
[CUSTOMER][NEUTRAL] 01780690 M like Mary, L like Lima 8.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The member's last name is [PII]. First name is [PII].
[AGENT][NEUTRAL] OK. What's her date of birth?
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] To double the amount
[CUSTOMER][NEUTRAL] $16,719 even.
[AGENT][NEUTRAL] OK. Let me see if I can find this claim for you. And that was July [PII] of [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] the city.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so it looks like as of today, we have now received explanation of benefits from the primary insurance to continue the processing of this claim. So we're still waiting on that.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah, they
[CUSTOMER][NEUTRAL] OK. For the confirmation, uh, we have sent it to the fax number [PII]. Is this the correct uh correct fax that we have submitted?
[AGENT][MIXED] Yeah, that is the correct fast, but we have not received that. The only thing we received was one page, which is um just the, the form, the claim, just not the EOB attached to it.
[CUSTOMER][NEUTRAL] you can tell that
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] K as in
[CUSTOMER][NEUTRAL] Wait a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] May I know when was it received, when was it denied?
[AGENT][NEUTRAL] OK, the last one we received, because it was a processed twice, one is the original, the other one is a duplicate. And the last time that we received this information was [PII] and it was processed [PII].
[CUSTOMER][NEUTRAL] OK. So, may I know your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. That[PII] [PII].
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Do we need to submit uh to the same fax?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Could you please provide uh two more claims for the other patient?
[AGENT][NEUTRAL] Another member or the same member?
[CUSTOMER][NEUTRAL] Yeah, another member.
[AGENT][NEUTRAL] OK, yes, I just need to make a note on this one. Do you need any other information on this one?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, let me go ahead and make a note.
[CUSTOMER][NEUTRAL] OK. Uh, may I know the timely filing?
[AGENT][NEUTRAL] Um, we don't have time finding limits.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] What's the next policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Wait a little moment. I'll provide you with that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I'm searching here. Please wait a little moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, I found that the uh the policy number is 02511179 M like Mary, L like Lima.
[CUSTOMER][NEUTRAL] 7.
[AGENT][NEUTRAL] OK, what's the name and date of birth?
[CUSTOMER][NEUTRAL] Member name is [PII] is the initial. Date of birth, [PII].
[AGENT][NEUTRAL] OK, what's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Date of service [PII] and have date range to [PII].
[AGENT][NEUTRAL] OK, what's the amount?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's 152.
[CUSTOMER][NEUTRAL] And uh $13 even. 152013.00.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I'm looking for a claim for [PII].
[AGENT][NEUTRAL] The amount of $152,013.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me see if I can find this claim. One moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, looks like this one is needing the primary AOB as well.
[CUSTOMER][NEUTRAL] OK. So, we have already submitted it to the [PII]. Shall we resubmit it again to the same fax?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] When you have received and when it, it has been denied, may I know it?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] It was received [PII], processed [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Do you need any other information on this one?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] No. Shall we go to the other account? Other claim for the different patient?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No. Let me make a note.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Uh, OK, no worries. OK, OK.
[CUSTOMER][NEUTRAL] we're doing
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Good
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. What's the next policy?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] The next policy.
[CUSTOMER][NEUTRAL] This time
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It is 02462236 M like Mary.
[CUSTOMER][NEUTRAL] L like Lima 8.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] All right. What's the name and date of birth of the patient?
[CUSTOMER][NEGATIVE] It's not.
[CUSTOMER][NEUTRAL] Hm. [PII] is the initial. Date of birth [PII]. Date of service [PII].
[AGENT][NEUTRAL] OK, how much is the total charge?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] $14,740 even.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You said the date of service was [PII]?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, so [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, bear with me. Let me try again.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so this one also need the primary ERB and let me go ahead and see what day we process, one moment.
[CUSTOMER][NEUTRAL] Let
[CUSTOMER][NEUTRAL] So, we have submitted it to the same fax number that I provided you previously. Do we need to send it to the same fax?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] OK. When was it received? When was it denied?
[AGENT][NEUTRAL] It was received on [PII], processed the same date.
[AGENT][NEUTRAL] And it's just in, and then we need the primary ELB.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thanks for providing.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Not
[CUSTOMER][POSITIVE] Nothing else you have verified all the queries that I have and have a nice day. It's really nice talking to you. Thank you. Bye-bye.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome. Have a good day. Bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.