AccountId: 011433970860
ContactId: 053c29c6-4475-478c-8425-799472b97cb6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266929 ms
Total Talk Time (AGENT): 88099 ms
Total Talk Time (CUSTOMER): 92858 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/053c29c6-4475-478c-8425-799472b97cb6_20250117T17:39_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] My name is [PII] with Doctor [PII]'s office. I have a question on an EOB I received on a patient.
[AGENT][NEUTRAL] OK. Do you have a phone number I can get in case we get disconnected, I can call you back?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have their policy number?
[CUSTOMER][NEUTRAL] 00608462
[AGENT][NEUTRAL] Thank you. Hold on one moment, please.
[CUSTOMER][NEUTRAL] Mhm OK.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were needing benefits or claim status?
[CUSTOMER][NEUTRAL] Uh, I have a question on the EOB I got for [PII].
[CUSTOMER][NEUTRAL] Oh, it says that.
[AGENT][NEUTRAL] OK, and what was the question?
[CUSTOMER][NEUTRAL] Uh, with the bottom it says it was repriced according to our maximum care contract, but when I look on the actual EOB where it says provider discount, it says NA.
[CUSTOMER][NEUTRAL] So, did they do it, she's supposed to get our Carrington rates. Was that done or?
[AGENT][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Hold on, let me pull up the actual.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't remember her being responsible for that much before. I could be wrong though.
[AGENT][NEUTRAL] I do not see where it pulled in the network fee on the system, no, ma'am.
[AGENT][NEUTRAL] In net in the network field on the EOB, does it have anything?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, it's a provider discount NA.
[AGENT][NEUTRAL] And you all are providers?
[CUSTOMER][NEUTRAL] That's why I was
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hold on just a second, let me see what happened.
[AGENT][NEUTRAL] Let's see for [PII].
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] I'm not sure why I didn't pull it in because I see where you are a provider, [PII] DDS.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The GDC 104.
[AGENT][NEUTRAL] Schedule.
[CUSTOMER][NEUTRAL] Yeah, well, they just tell us the Carrington rates is what they tell us, so.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So can we just get it reprocessed so it doesn't look like she owes as much or?
[AGENT][NEUTRAL] Do you have the check there?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] It would be easier if you sent the check back where we could reprocess it where the fees would come in.
[CUSTOMER][NEUTRAL] OK, do I need to wait for you to request it or I have to write a letter explaining y'all need to do it right?
[AGENT][NEUTRAL] You can just put a note on there and mail the check back to us would be the easiest way to do it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Since you still have the check in hand.
[CUSTOMER][NEUTRAL] Alright, as long as they don't spread it, yeah.
[CUSTOMER][NEUTRAL] OK, I'll try that.
[AGENT][NEUTRAL] And just put a note on there saying it did not, uh, have the network fee on it and you all are providers.
[CUSTOMER][POSITIVE] Let me process correctly, OK, I can do that. Thank you so much.
[AGENT][POSITIVE] Thank you. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, ma'am, that was it.
[AGENT][POSITIVE] Thank you, [PII] for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.