AccountId: 011433970860
ContactId: 0283a7f6-5999-447e-84e7-1ff419062245
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 594890 ms
Total Talk Time (AGENT): 158433 ms
Total Talk Time (CUSTOMER): 194308 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/0283a7f6-5999-447e-84e7-1ff419062245_20250321T13:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII]. I'm calling from Fife Therapy Services in [PII]. Um, I was attempting to look up a claim on your online service center, and whenever I type in our tax ID and the patient account number, it says that there's, uh, nothing that can be found, um, and I was wondering if you could help me with that.
[AGENT][NEUTRAL] OK, um, have you?
[AGENT][NEUTRAL] Received payment from us before?
[AGENT][NEUTRAL] Or EOBs from us before because.
[CUSTOMER][NEUTRAL] Um, we have.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, but not for this particular patient.
[AGENT][NEUTRAL] OK, um, let's see.
[AGENT][NEUTRAL] Let me
[CUSTOMER][NEGATIVE] The the problem that says I believe we have at least it says no user was found with the information that was entered.
[AGENT][NEUTRAL] OK, let me pull up our admin site real quick and see if we've got you in there.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] What's your tax ID?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And I'm not showing you in there either.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Pulling up our guide, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, let me pull that up real quick.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It's 02100475.
[AGENT][NEUTRAL] And do you have the patient name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII] good [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What office did you say you're with again? I'm sorry.
[CUSTOMER][NEUTRAL] Fife Therapy Services, it's F I F E.
[AGENT][NEUTRAL] That's like I see.
[AGENT][NEUTRAL] [PII], can I get a good callback number just in case I lose you?
[CUSTOMER][NEUTRAL] Yeah, sure, it's [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] What was the last data service you filed with us for her?
[CUSTOMER][NEUTRAL] Um, let's see here.
[CUSTOMER][NEUTRAL] It looks like 12 the last date of service was [PII].
[AGENT][NEUTRAL] Just seeing if we have a claim on file.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, I see a claim on file so you should be able to.
[AGENT][NEUTRAL] Log in
[AGENT][NEUTRAL] Um, let's see, so when you're setting it up, have you ever been on the site before or able to log into the portal?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I have it usually um I think in the past we've gotten like a paper EOB that's been mailed to us but I've never been I've never attempted to log on.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have access to look at it right now with me?
[CUSTOMER][NEUTRAL] Uh, yeah, I can. Mhm.
[AGENT][NEUTRAL] OK, OK, um, yeah, if you'll go to that secure.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then it looks like we don't have you in the system so we would be basically be registering as a new.
[AGENT][NEUTRAL] User
[CUSTOMER][NEUTRAL] OK. And then I went to, I'm a medical or
[AGENT][NEUTRAL] So I'm not pulling up your tax ID and our admin.
[AGENT][NEUTRAL] Yeah, medical or dental.
[CUSTOMER][NEUTRAL] The medical or dental provider one?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Of course enter your tax ID.
[AGENT][NEUTRAL] And then do you file on the 1500s?
[AGENT][NEUTRAL] That we file on, you know, file on the UBO4, OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So we would utilize the patient's account number for box 26 on the 1500.
[CUSTOMER][NEUTRAL] OK, let me find that.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, I'll put that in and it says no user was found.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, do you have the
[AGENT][NEUTRAL] Patient account number from that claim that 124.
[CUSTOMER][NEUTRAL] Yeah, let me see from the 124.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Would be
[CUSTOMER][NEUTRAL] F as in Frank. I as in indigo. F as in Frank 005033.
[AGENT][NEUTRAL] OK, that's what's in [PII] on the 1500.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh wait, it just let me do it it just went through.
[AGENT][NEUTRAL] Let me see.
[AGENT][POSITIVE] It did OK.
[CUSTOMER][NEUTRAL] Now it says yeah it says create your account now because I what I used was.
[CUSTOMER][NEUTRAL] I used it from a different date of service so I wonder if maybe you guys didn't get that particular date of service.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I might be.
[AGENT][NEUTRAL] That it's the first claim that we have on file maybe uh you've received, you've uh processed or received EOBs from us for a different claim or date of service before this.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] Is that right? 4 124?
[CUSTOMER][NEUTRAL] So I haven't received any for, for this patient. Um, she's got 4 dates of service on file and it looks like the earliest is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, but we haven't like her primary insurance has been taking forever to process the claims, so it looks like we just got.
[CUSTOMER][NEUTRAL] From her primary insurance, a couple of these like 102, 1021 and 124, but there's still one outstanding for another date of service in October so I'm just wondering if you guys have it.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Would you guys get that from like it would have to be after the primary process is it?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yeah, so we do yeah it looks like we have some denials on file for needing that primary.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] EOB so you can upload those um to the portal when you finish setting that up and.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You can just reference the date of service. You don't have to submit the 1500 again.
[AGENT][NEUTRAL] Um, and then we can get those processed, um, based on, you know, the policy that she.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] As
[CUSTOMER][POSITIVE] OK perfect so just upload the primary EOB got you.
[AGENT][NEUTRAL] What the primary, you know, considering the primary.
[AGENT][NEUTRAL] Yes, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Cool, OK, account was successfully created awesome.
[AGENT][POSITIVE] Oh, perfect, great.
[CUSTOMER][POSITIVE] And I can look it up. Perfect, thank you so much. I really appreciate your help.
[AGENT][NEUTRAL] OK, anything else I can help you with today?
[CUSTOMER][NEUTRAL] I don't think so. I will look those up and then I'll get those submitted um on the portal.
[AGENT][POSITIVE] OK perfect thank you I hope you have a great day and thanks for calling.
[AGENT][NEUTRAL] On APL.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.