AccountId: 011433970860
ContactId: 09c2ec36-33f8-4022-8d4b-c429b3069c14
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2012010 ms
Total Talk Time (AGENT): 651393 ms
Total Talk Time (CUSTOMER): 654243 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/09c2ec36-33f8-4022-8d4b-c429b3069c14_20250211T14:04_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. I'm [PII] calling from provider office to check claim status.
[AGENT][POSITIVE] Money, it would be my pleasure to assist you with that claim status. What is the callback number, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, the callback number is [PII] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, the member ID is 1224175ML8.
[AGENT][NEUTRAL] And the patient's name and date of birth, please, ma'am.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The patient name is [PII] and the date of birth is on [PII].
[AGENT][POSITIVE] All right, thank you. And [PII], I'll be happy to assist you with that claim status. Do you have a claim number or date of service for [PII]?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, the date of service is on [PII].
[AGENT][NEUTRAL] I don't have a claim on file for [PII].
[CUSTOMER][NEUTRAL] [PII], uh, let me check once again, just a second.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] No claim on file, right?
[AGENT][NEUTRAL] That is correct, not for that data service of [PII].
[CUSTOMER][NEUTRAL] OK. Well, we can resubmit once again. Uh, may I know the correct mailing address?
[AGENT][NEUTRAL] The correct
[CUSTOMER][NEUTRAL] To resubmit once again?
[AGENT][NEUTRAL] Sure, the correct billing address is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK. Can you spell it? What was that? Uh, uh, [PII], what was that? [PII], can you spell it, please?
[AGENT][NEUTRAL] And also,
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hello, uh, sweetie.
[CUSTOMER][NEUTRAL] [PII]. OK, got it uh.
[AGENT][NEUTRAL] Let me check something real quick, bear with me just one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] She may have another policy. Let me check.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You know what, let me check this policy.
[AGENT][NEUTRAL] That policy number you gave me was an old one, so let me check this one. Hey, I think I might have found it. OK, let me give you her correct policy number that is active.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The correct policy number as of [PII] is 189.
[AGENT][NEUTRAL] 1721.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I do apologize.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And what was the bill amount on that?
[AGENT][NEUTRAL] 1111, 20.
[CUSTOMER][NEUTRAL] Yes, uh, bill, yeah, the bill amount is $8,066.80.
[AGENT][NEUTRAL] And the provider name?
[CUSTOMER][NEUTRAL] Uh, we are calling from the facility. So the facility name is Early Cross Hospital.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Excuse me.
[AGENT][POSITIVE] All right. I do apologize, [PII]. We do have that claim on file, and I can provide that information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] Let's see, bear with me just one second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We received the claim on [PII].
[AGENT][NEUTRAL] And processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] With the payment of $38.87 to Holy Cross Hospital.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, may I know the claim number?
[AGENT][NEUTRAL] Yes, ma'am. The claim number is 3561047.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 1047. OK. Um, may I know the payment details?
[AGENT][NEUTRAL] Sure, it was paid single check.
[CUSTOMER][NEUTRAL] Uh, check number, yeah.
[AGENT][NEUTRAL] Mhm. It was a single paper check, check number 202.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 689 4
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, when was the payment was made? Pay date?
[AGENT][NEUTRAL] It was issued on [PII].
[CUSTOMER][NEUTRAL] [PII]. All right.
[CUSTOMER][NEUTRAL] And check.
[CUSTOMER][NEUTRAL] OK, got it. Uh, um, may I get the UB through fax?
[AGENT][NEUTRAL] No, we do have a provider portal.
[AGENT][NEUTRAL] You have instant access to EOB's claim status as well as claim submission.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I can help you create a login and password or I can fax it.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, OK. Uh, what is the website name?
[AGENT][POSITIVE] It's secured, that's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you're just uh mhm you would go in as a new user and that you're a medical or dental provider.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And to create, yeah me and then you'll just use your tax ID number and the patient's account number listed in box 3A on the UBO4.
[CUSTOMER][NEUTRAL] Medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And I can provide that account number if you need, so you don't have to look it up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If you want to create that, I don't mind staying on the line to make sure you.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK. I'll create it, uh, just a minute, uh, [PII].
[AGENT][NEUTRAL] you'll be.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][POSITIVE] I'll create it, yeah.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] What about.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Uh, it is showing like, uh, an email was successfully sent to our department will be in our contact with you shortly.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Maybe it takes the time to access.
[AGENT][NEGATIVE] It shouldn't take
[CUSTOMER][NEUTRAL] To get access, yeah.
[AGENT][NEUTRAL] Let's see, let me check.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] It.
[AGENT][NEUTRAL] Well, it looks like there may be some lag time.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Yeah, it looks like they're having some technical issues. What I can do is I can fax this to you. Let me just get that pulled up and faxed to you, but for the future, you should, excuse me, I apologize.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] That's OK. Uh mhm.
[AGENT][NEUTRAL] You should be um able to get the EOBs instantly by having that.
[AGENT][NEUTRAL] Account created.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Let me prepare it for you. I apologize.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, it looks like it might have corrected itself. Have y'all received anything?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Did you receive that text yet?
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Because it looks like it's fixed now.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Can I put this back to your attention, [PII]?
[CUSTOMER][NEUTRAL] Yeah, um, OK, uh, I'm aha.
[AGENT][NEUTRAL] And [PII], what is that fax number please ma'am?
[CUSTOMER][NEUTRAL] Yeah, uh, it is, uh.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And just to verify that fax number, I'm sending this EOB to [PII].
[CUSTOMER][NEUTRAL] Any
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] Mhm. It's 2452.
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] All right, thank you. I appreciate that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And I do apologize for the website.
[CUSTOMER][NEUTRAL] Uh, that's OK, [PII]. I will try once again later. Uh, may I get the call reference on this?
[AGENT][NEUTRAL] Call reference number is my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] OK. Uh, I do have a few more claims. Can you assist me on that?
[AGENT][NEUTRAL] I would be happy to, [PII]. What's that next policy number? Is it or was it for the same member?
[CUSTOMER][NEUTRAL] Uh, let me check just a second. Uh-huh, no, it's for a different, uh, number.
[AGENT][POSITIVE] All right, I'm ready.
[CUSTOMER][NEUTRAL] Yeah, um, the next number ID here.
[CUSTOMER][NEUTRAL] Uh, yeah, it's 01578526 ML 8.
[AGENT][NEUTRAL] Thank you, [PII]. And what is that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, the patient name is [PII] and the date of birth is on [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And what is Elaine's data service?
[CUSTOMER][NEUTRAL] Yes, the date of service is on [PII]. No, no, no, no, no, sorry, uh, it, it is on [PII].
[CUSTOMER][NEUTRAL] And the bill amount is $6,575.40.
[AGENT][NEUTRAL] Thank you. Same provider?
[CUSTOMER][NEUTRAL] Yeah. Uh, the facility is Holy Cross Hospital.
[AGENT][NEUTRAL] Alright, thank you, [PII], and that claim we received on 10-24-24.
[AGENT][NEUTRAL] And was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that claim was denied.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEGATIVE] And it was denied because the outpatient benefit for the calendar year has been met.
[CUSTOMER][NEUTRAL] But, OK, yeah.
[CUSTOMER][NEUTRAL] Uh, may I know the claim number under this?
[AGENT][NEUTRAL] The claim number is 352.
[AGENT][NEUTRAL] 2310.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Got it. Uh, when was the claim denied uh?
[AGENT][NEUTRAL] It was denied on 10-25-24.
[CUSTOMER][NEUTRAL] 25, 24.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What is the member's eligibility uh with the payment?
[AGENT][NEUTRAL] Mhm. The effective date is [PII] and the policy is current.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Their outpatient maximum benefit is $2500 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And the call reference number will be the same, right?
[AGENT][POSITIVE] Yes, ma'am, that is correct.
[CUSTOMER][NEUTRAL] OK, can I proceed the next member ID?
[AGENT][NEUTRAL] Yes, ma'am, give me just one quick second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] I'm ready for the next one, [PII].
[CUSTOMER][NEUTRAL] Yeah, uh, the next member ID is 01816171.
[AGENT][NEUTRAL] And what is that name and date of birth?
[CUSTOMER][NEUTRAL] Yes, uh,
[CUSTOMER][NEUTRAL] The patient name is [PII], sorry, it's [PII] and the date of birth is on [PII].
[AGENT][NEUTRAL] All right, thank you, and that date of service?
[CUSTOMER][NEUTRAL] Yes, the date of service is on [PII] of uh.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] And that build out, please, ma'am.
[CUSTOMER][NEUTRAL] Yes, and the bill amount is $16,255255.50.
[AGENT][NEUTRAL] That looks like a different provider name. What's that provider name?
[CUSTOMER][NEUTRAL] Uh, we don't have a provider name. It's from Saint Mary's.
[AGENT][NEUTRAL] Facility name?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Saint Mary's Scotts Medicine Hospital.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Alright, that claim we received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Process on [PII] with the payment of $1140.40.
[AGENT][NEUTRAL] Sent to Good Samaritan Hospital.
[CUSTOMER][NEUTRAL] OK, I did uh.
[CUSTOMER][NEUTRAL] Uh, may I know the claim number?
[AGENT][NEUTRAL] Claim number is [PII].
[AGENT][NEUTRAL] 8610.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Uh, when, when was the payment was made?
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] And it was cleared on?
[AGENT][NEUTRAL] I can check that. Bear with me.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It cleared on [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Let me.
[CUSTOMER][NEUTRAL] OK. May I know the check number?
[AGENT][NEUTRAL] Check number is 201.
[AGENT][NEUTRAL] 3286.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, is that a single check or uh bulk amount?
[AGENT][NEUTRAL] Single paper check.
[CUSTOMER][POSITIVE] Good, good. OK, uh, is there any liability?
[AGENT][NEUTRAL] We don't determine patient responsibility. We only pay toward the deductible, co-pay or co-insurance. We're secondary.
[CUSTOMER][NEUTRAL] Oh, OK. OK.
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] Got it. Um,
[CUSTOMER][NEUTRAL] OK, can I proceed the next one?
[AGENT][NEUTRAL] All right, one quick second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, the member ID is 1,067,610.
[AGENT][NEUTRAL] What is that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient name is [PII] and the date of birth is on [PII].
[AGENT][NEUTRAL] Thank you. And that date of service for [PII]?
[CUSTOMER][NEUTRAL] Yes. The date of service is on [PII], and the bill amount is $19,057.30.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the facility name?
[CUSTOMER][NEUTRAL] Yes. The facility name is Ori Cross Hospital.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm checking. We did receive the claim. Let me get you the received date.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That claim we received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Processed on [PII].
[AGENT][NEUTRAL] And this claim was denied as services were rendered after the policy termed.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, may I know the claim number?
[AGENT][NEUTRAL] Claim number is 354.
[AGENT][NEUTRAL] 393 6
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, got it. Uh.
[CUSTOMER][NEUTRAL] Uh, per call, how many can you assist me, ma'am?
[AGENT][NEUTRAL] How many do you have?
[CUSTOMER][NEUTRAL] Uh, I do have a.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I do have uh one more.
[AGENT][POSITIVE] OK, I'll be happy to assist you with the next one.
[CUSTOMER][POSITIVE] Yeah, OK, thank you.
[AGENT][POSITIVE] You're welcome. I'm ready for that policy number.
[CUSTOMER][NEUTRAL] Yes, uh,
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] OK. Uh, and this patient, uh, for, uh,
[CUSTOMER][NEUTRAL] I do have a 44 DOS uh data of service.
[AGENT][POSITIVE] Not a problem.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][POSITIVE] I that's too funny.
[CUSTOMER][NEUTRAL] OK. Uh, the member ID is 0163 consecutive 961ML7.
[AGENT][NEUTRAL] And this patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, um,
[CUSTOMER][NEUTRAL] The patient name is [PII] and the date of birth is on [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And you said we have 3 dates of service. What is that first date of service?
[CUSTOMER][NEUTRAL] Yes, um,
[CUSTOMER][NEUTRAL] The date of service is on [PII].
[AGENT][NEUTRAL] OK, alright, hang on just a second, let me check something. We don't have that claim on file, but it could be under another policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because this policy turned on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me give you the correct policy number for anything after [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The correct policy number is 247.
[AGENT][NEUTRAL] 3136.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 26.
[AGENT][NEUTRAL] And that is after, um, [PII].
[AGENT][NEUTRAL] And the this policy turned on [PII], so what did you say that bill amount was again? I do apologize.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah. Uh, the bill amount is $312 even.
[AGENT][POSITIVE] Alright, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that claim we received on 11-11-2024.
[AGENT][NEUTRAL] It was processed on 11-12-2024.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And this claim was denied.
[AGENT][NEUTRAL] As
[AGENT][NEUTRAL] Kinesiology, speech, or occupational therapy is not covered for the patient's policy.
[CUSTOMER][NEUTRAL] Oh, OK, let me note it just a second.
[CUSTOMER][NEUTRAL] OK, got it. Uh, may I know the claim number?
[AGENT][NEUTRAL] Claim number 352.
[AGENT][NEUTRAL] 8961.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Got it uh.
[CUSTOMER][NEUTRAL] Uh, what was the, the 98?
[AGENT][NEUTRAL] 1112, 2024.
[CUSTOMER][NEUTRAL] OK, got it uh.
[CUSTOMER][NEUTRAL] OK. Can I, can we go to the next uh date of service?
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] Mhm. Uh, the next date of service is on [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And under the
[CUSTOMER][NEUTRAL] Yeah, and the bill amount of $618 even.
[AGENT][NEUTRAL] For [PII], I don't have a claim on file.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We're submit once again, uh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, can you repeat the, uh, mailing address once again?
[AGENT][NEUTRAL] Sure. It's [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[AGENT][NEUTRAL] You can also fax that with the primary EOB directly to our claims department.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Our fax number is 877.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Got it, uh, but I think you know.
[AGENT][NEUTRAL] Claims
[CUSTOMER][NEUTRAL] Claims and the timely filing limit?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] OK, can I proceed the next, uh, date of service?
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] And the bill amount is, yeah, $32312 even.
[AGENT][NEUTRAL] And then
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that claim we do have on file.
[AGENT][NEUTRAL] Received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Processed on [PII], and that claim was denied for the same reason. Kinesiology, uh, speech or physical therapy is not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, but
[CUSTOMER][NEUTRAL] Got it. Uh, and the last, uh, detail service, it is, uh,
[CUSTOMER][NEUTRAL] On [PII].
[AGENT][NEUTRAL] OK, and did I give you the claim number for [PII]? Did I give you that?
[CUSTOMER][NEUTRAL] Uh, uh, no, no, I'm so sorry. I just forgot. Yeah, yeah.
[AGENT][NEUTRAL] Would you, would you like that?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Alright, the claim number for [PII] is 352.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] 8960.
[CUSTOMER][POSITIVE] Got it, uh, thank you.
[AGENT][POSITIVE] Mm, my pleasure. OK, for [PII] for $576?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And processed on [PII] and denied for the same reason, not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, got it uh.
[CUSTOMER][NEUTRAL] And call reference number will be the same, right? And may I get the claim number?
[AGENT][NEUTRAL] Yes, I was gonna make sure you get the claim number.
[CUSTOMER][NEUTRAL] that
[AGENT][NEUTRAL] For [PII], that claim number is 354.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] 856 7.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 67. OK, got it though.
[CUSTOMER][POSITIVE] Uh, thank you for assisting me, ma'am. Um.
[AGENT][POSITIVE] [PII], it's been my pleasure to assist you with that claim status. Try to get that, um,
[CUSTOMER][POSITIVE] Have a great day.
[AGENT][POSITIVE] Portal set up and I think that you'll find it's gonna be very helpful.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, um, should I want to register once again?
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me see if it looks like it was.
[AGENT][NEGATIVE] I would like it might still be having problems.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But you can try.
[CUSTOMER][NEUTRAL] OK. Uh,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. Uh, should I want to register once again? It is showing to regis uh register poster.
[CUSTOMER][NEUTRAL] Team
[AGENT][NEUTRAL] Uh, I, yeah, I might wait just a little bit longer. It looks like it's still having issues.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Looks like it's not responding the server's not, so I would maybe uh later today try to create that account.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Um, OK. OK.
[AGENT][NEUTRAL] It is, it is a self-registration account, so.
[CUSTOMER][POSITIVE] Oh, yeah. I'll try later once again. And uh thank you for assisting me, ma'am. Uh, have a great day.
[AGENT][POSITIVE] [PII], I hope you have a great day as well and thank you for calling APL. You take care.
[CUSTOMER][NEUTRAL] You too, bye.
[AGENT][NEUTRAL] Bye bye.