AccountId: 011433970860
ContactId: 036d8793-976d-47a9-8d6e-5c083d17eba6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 363880 ms
Total Talk Time (AGENT): 111669 ms
Total Talk Time (CUSTOMER): 162094 ms
Interruptions: 4
Overall Sentiment: AGENT=1.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/036d8793-976d-47a9-8d6e-5c083d17eba6_20250228T15:26_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from the business office of Brookwood Medical Center to check on a claim status for quality and training purposes. This call is being recorded and monitored.
[AGENT][POSITIVE] I'm happy to check on a claim status for you today, [PII]. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Policy number is 02539176.
[CUSTOMER][NEUTRAL] I'm
[AGENT][NEUTRAL] All right, thank you. Let me pull this up here, one moment.
[CUSTOMER][NEUTRAL] yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] May I please have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] I'm sorry, [PII], can you repeat that policy number to me one more time?
[CUSTOMER][NEUTRAL] Sure. It is 02539176.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Very.
[AGENT][NEUTRAL] 539.
[AGENT][POSITIVE] All right, thank you so much. And then what's the date of service?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Date of service is [PII] of this year. The bill amount is $4,375 even.
[CUSTOMER][NEUTRAL] Yeah, I'm not
[AGENT][POSITIVE] Thank you so much. Let me take a look here. One moment, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hey.
[CUSTOMER][NEUTRAL] So I can drop
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Well let me
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] you
[AGENT][NEUTRAL] OK, so it looks like we got this claim a couple of times, [PII], um.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The claim was originally received on [PII].
[AGENT][NEUTRAL] Uh, the claim was denied. It looks like the denial states were unable to assign benefits to the provider.
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] And you.
[AGENT][NEUTRAL] Uh, due to a discrepancy with the tax ID?
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] So a letter was sent to the provider uh with instructions to resolve this, and this was on [PII].
[CUSTOMER][NEUTRAL] Um, may I know which tax ID do you, um, are you referring to? Is it the physician or?
[CUSTOMER][NEUTRAL] The, um, provider itself.
[AGENT][NEUTRAL] It states the provider, so.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's DNP.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] However, um, upon checking and verifying.
[CUSTOMER][NEUTRAL] Uh, the NPI of the provider is in [PII] State, so that is.
[CUSTOMER][NEUTRAL] Um, like it is aligned to the needed information.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] So the provider needs to resolve the discrepancy with our office, um.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] We.
[AGENT][NEUTRAL] The information that we received was from the Brookwood Baptist Medical Center, so that's where the discrepancy is.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK. Will there be any possible that you can send this claim back for the process?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Um, we're not able to reprocess it until we receive some sort of communication from the provider regarding the tax ID number. We haven't received anything it doesn't look like at this time.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Alright, and I'll just get a call reference number before [PII]'s call.
[AGENT][NEUTRAL] Call reference is my name with my last initials in today's date. My name again is [PII], that's [PII] My last initial is [PII], and then today's date.
[CUSTOMER][NEUTRAL] you can talk about it.
[CUSTOMER][POSITIVE] Alright, thank you very much for your assistance. You've been a great help. Keep safe and goodbye.
[AGENT][POSITIVE] Have a good day, [PII]. Bye-bye.