AccountId: 011433970860
ContactId: 0dbc1932-00b1-4451-bfa2-2a18cc1a84db
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 892159 ms
Total Talk Time (AGENT): 314336 ms
Total Talk Time (CUSTOMER): 550363 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/0dbc1932-00b1-4451-bfa2-2a18cc1a84db_20250210T16:10_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII]. I actually spoke with you back on the [PII], and uh you were needing my admission date and charges for my, uh, stay, and, um, I, um, did the medical records and was I requested the medical records to have them faxed to you guys at [PII] attention claims, and I was seeing if you received them.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, what's your policy number, [PII], and I can check for you.
[CUSTOMER][NEUTRAL] 02435427. I apologize, I'm losing my voice.
[AGENT][NEUTRAL] And I
[AGENT][NEUTRAL] Oh, that's OK and what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], verify your date of birth, mailing address and email.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] [PII] and my email is [PII].
[AGENT][NEUTRAL] OK, thanks for that information. And you said that you submitted the admission discharge information. Was it around the [PII]?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It was uh medical records I requested them on the [PII], so did you receive them?
[AGENT][NEUTRAL] OK, let me see.
[CUSTOMER][NEGATIVE] Cause I had to do it, I had to do it online cause I, I couldn't go.
[CUSTOMER][NEUTRAL] When you're working, you can't go get them and I did take today off because I was hoping our Chiefs were gonna win the Super Bowl.
[CUSTOMER][NEUTRAL] So I took the day off to sleep in and then to make all kinds of phone calls.
[AGENT][NEUTRAL] Right.
[AGENT][MIXED] That was, uh, well, I can't say it was a good game, but um I was for the Eagles.
[CUSTOMER][NEUTRAL] Oh [PII]
[CUSTOMER][POSITIVE] Oh well good for you congratulations.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Bittersweet, bittersweety.
[CUSTOMER][NEGATIVE] No, you guys, you guys, you guys blew us out of the water.
[AGENT][POSITIVE] Man, you know, both teams are good. I think a lot of people went in, you know, since the Chiefs had it for the last 2 years, the, the state champion or the championship. Um, I think, you know, they, you know, some people felt that they had the leverage, which is awesome team. I mean, both teams are awesome. Um, but it was just something about, uh,
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][POSITIVE] [PII]'s quarterback, I mean, he's always calm and humble.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] You know, and so it, it was, it was a bittersweet, you know, I want it to be like a really good game, you know.
[AGENT][NEUTRAL] Like 7 to 7, 1414, you know, that kind of game.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Did you send something to us on the [PII]?
[AGENT][NEUTRAL] I see I see a document received on the [PII] because your last claim was
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, well, that
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well that could, I mean this was you guys needed um my itemized hospital bills with the admission discharge dates and time.
[AGENT][NEUTRAL] And, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And, and [PII]'s, the itemized bill that they also gave me with EUB didn't have that. So the only way she said only my medical records would have that. So, um,
[CUSTOMER][NEUTRAL] I asked when I, I had to request them online and I asked him to fax to you guys at [PII] attention claims.
[AGENT][POSITIVE] Yeah, we did receive something on the [PII] and we processed a benefit of $100. Did you get that?
[CUSTOMER][NEUTRAL] It does
[CUSTOMER][NEGATIVE] No, I got that the day I talked to you. I have that, but this is for my big hospital bill.
[AGENT][NEGATIVE] OK, OK. Right. I don't show anything else received.
[AGENT][NEUTRAL] I don't show
[CUSTOMER][NEUTRAL] OK, yeah, when, because when I talked to you on the [PII], you said yes, go ahead and cash that $100 check so I.
[AGENT][NEUTRAL] And you could have, because that's, that's the emergency room, uh, visit. So, yeah, that's fine. Yeah.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] That was the emergency room doctor I thought, but, but I mean my my hospital bill, my hospital bill is huge, um, that I, yeah, so.
[AGENT][NEUTRAL] Yes, it is.
[AGENT][NEUTRAL] Yeah, I see it.
[AGENT][NEUTRAL] Yeah, I see it. So who did you have fax the information to us?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Um, it would be Saint Luke's East Hospital.
[AGENT][NEUTRAL] OK, so I, we've not received it from Saint Luke's.
[CUSTOMER][NEUTRAL] OK, I will, um, make a phone call to them here and see what the heck's going on. I'm off today.
[AGENT][NEUTRAL] Yeah, what fax number did you give them?
[CUSTOMER][NEUTRAL] Um, [PII] told me to have them faxed to [PII] attention claims.
[AGENT][POSITIVE] Correct, that is correct.
[AGENT][NEUTRAL] And when did you say they were to have, uh, send it to us? Did you say the [PII]?
[CUSTOMER][NEUTRAL] Um, I I I requested them online on [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Last week, so.
[AGENT][NEGATIVE] Yeah, at this moment, we've not received anything.
[CUSTOMER][NEUTRAL] All right, well, I'll give them a call and since I'm off today, oh, and [PII] had told me to get an updated UB and itemized bill, but like I said, Saint [PII]'s East told me it would be the same as what I faxed you previously, so they said the only way you'd get my admission dates and uh times and admission discharge date and time is from the medical records, so.
[AGENT][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] Oh, I'll just get a hold of [PII]'s if I have to go by there, pick them up myself, I guess I will.
[AGENT][NEUTRAL] Right, um.
[CUSTOMER][NEUTRAL] Since I'm on that.
[AGENT][NEUTRAL] Yeah, so, uh, we're specifically requesting what we were, you know, um, the, the itemized bill with the hospital admission and discharge dates and times, yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right, well, like I said, like I said, I've already faxed you the UB.
[CUSTOMER][NEUTRAL] And everything, but they, [PII]'s specifically said that they don't put that on their UB so the only way you get that information is if I send you the medical records.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Which is what we put in the ELB that you received, so that is correct.
[CUSTOMER][NEUTRAL] Uh, uh, we'll just have, have them get you the medical records and then I should be good to go.
[AGENT][NEUTRAL] Well, the, the, um, the remark code that you received on the EOB, it also states the itemized bill. There are different types of itemized bills that the hospital send.
[AGENT][NEUTRAL] Um, and the one that, that we're looking at is the UV 04, which is the standard one that has your diagnosis code and everything on it.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, so I see that.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well, I can send itemized bill. I've got that. It just doesn't have the admission dates and times either.
[CUSTOMER][NEUTRAL] And do you want me to fax that to the [PII] also?
[AGENT][NEUTRAL] Yeah, well, it does say you arrived [PII] or the from date is [PII], and I think when I spoke with you the last time it doesn't show any uh like room and board like you were you were admitted.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, it doesn't even show observation hours, so we don't know how long you were there technically.
[CUSTOMER][NEUTRAL] Right, but I work.
[CUSTOMER][NEUTRAL] Yeah, no, I
[CUSTOMER][NEUTRAL] Right, I know, I was admitted, so, um, let me look at while I've got you. I'll tell you what my itemized bill has. I, I, I just said well.
[AGENT][NEUTRAL] Yeah, I'm looking at it.
[CUSTOMER][NEUTRAL] You have my itemized bill also or just CUV?
[AGENT][NEUTRAL] Uh-huh, I'm looking at it.
[AGENT][NEUTRAL] Yes, that's the UBO4. Same thing itemized bill for the hospital is a UBO4 which you did send.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, I think, yeah, I know that. I, you know, I think claims myself, but I do have an itemized bill that.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] what he did, and I can fax that to you, but it just doesn't again it doesn't show my admission date and now I just have the doggone thing and you think I could find it.
[AGENT][NEUTRAL] Is it, is it similar to the one that you've already sent?
[CUSTOMER][NEUTRAL] No, that was just the UBI sent, but I also have, I also have an itemized itemization showing 47, you know, it shows the sterile water blah blah blah blah blah blah I mean it shows all that.
[CUSTOMER][NEUTRAL] I'll just fax the.
[AGENT][NEUTRAL] Yeah, so does the one that you sent us. It's itemized.
[AGENT][POSITIVE] It shows everything that they did.
[CUSTOMER][NEUTRAL] OK, so I did that that with to you as well. I didn't think you have that.
[AGENT][NEUTRAL] Yeah, so this one
[CUSTOMER][NEUTRAL] And it shows the amount was $42,074.45.
[AGENT][NEUTRAL] Uh, this one shows $56,099.27.
[CUSTOMER][POSITIVE] Oh yeah, that's right, that's right.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's right, sorry.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But I have one that shows like everything they did, you know, all the lidocaine, blah, blah, blah blah blah. My my post procedure recovery, my recovery room.
[AGENT][NEUTRAL] Yeah, that's on this one too.
[CUSTOMER][POSITIVE] It is OK.
[AGENT][NEUTRAL] Yeah, the recovery room is on this one. A lot of Jacos which were injections, which was probably the lidocaine.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Um, CAT scan or CT scan, physical therapy, anesthesia. Yeah, so this one is itemized as well. It just doesn't show a room and board charge. It usually say R and B.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah. OK, I, I didn't.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] That's what's not on here and um and so that's what they're trying to to determine.
[CUSTOMER][NEUTRAL] Right. Um.
[CUSTOMER][NEUTRAL] But, um, and basically, [PII] told me my medical records will, you know, show that, so.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Yeah, so let them know that we have not received it.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] I will.
[CUSTOMER][NEUTRAL] I'm gonna call them here in just a second.
[AGENT][NEUTRAL] Yeah, and then today is the [PII], so that's not too far from this, you know.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] I mean, I used to
[CUSTOMER][NEUTRAL] Fax medical records all the time but um
[AGENT][NEUTRAL] So you understand.
[CUSTOMER][NEUTRAL] Yeah, well, yeah, I mean, I've been paying claims since the [PII].
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I need to be tired, let me tell you so.
[CUSTOMER][NEUTRAL] I will give them a.
[AGENT][NEUTRAL] What do you do you process major medical claims or?
[CUSTOMER][NEUTRAL] Oh yeah, all day long.
[AGENT][POSITIVE] Oh, how cool is that? Who do you work for?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Well, I'm a vendor of Blue Cross.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I, I worked, so, well, I've worked for third party, um, administrators for years, um.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh, like everywhere I work kind of closes and then are you familiar with Cerner Corporation?
[AGENT][NEUTRAL] Say it again.
[CUSTOMER][NEUTRAL] Do you remember, are you familiar with who [PII] [PII] was, which now by Oracle? Yeah, I did. I insurance and billing for them. I used to do their bill billing.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] The coding and all?
[CUSTOMER][NEUTRAL] So I used to, yeah, I used to work in I used to work in revenue cycle.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, that's, yeah, that's fine.
[CUSTOMER][NEUTRAL] I, I'm, I, I'm actually a certified dental assistant.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I, I, I used to even work in the OR at the hospital doing dental rehabs back in the day.
[AGENT][POSITIVE] Oh, wow
[CUSTOMER][POSITIVE] But no, I, I, I trust me, if I wasn't divorced, I'd be, um, I'd be retired.
[AGENT][NEUTRAL] You would be retired.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Oh yeah, I would. I'm, but no, I'm so pretty much all these companies I've been with, I've had longevity and they've closed and so my friends call me the closer, but um anyway.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, so long and short of it though, um, I worked for, so I went to Blue Cross. Well, I ended up working at AdventHealth on Mission Hospital too after Cerner closed. And then they, after that, they started sending all their stuff to [PII]. So they did a bunch of layoffs. And then I went to Blue Cross. Well, after 3 years with Blue Cross, my whole team, they got rid of, they laid us all off, and a company called Cobalt picked us up.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] So, so I've been with them 3.5 years, but actually last July, we rebranded and now we're called Clarity. It's just getting healthcare is getting ridiculous.
[AGENT][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] I've seen it all.
[AGENT][NEUTRAL] You got a lot of
[CUSTOMER][NEUTRAL] I used to, I used to, I used to type up reauthorizations on a typewriter.
[AGENT][NEUTRAL] Oh wow, so you're saying, yeah, that was ages ago.
[CUSTOMER][NEUTRAL] Yeah, so old. I'm, I'm gonna be [PII] this year, so.
[AGENT][NEUTRAL] You're still young
[CUSTOMER][NEUTRAL] Oh, I guess
[AGENT][NEUTRAL] That's young, that's young.
[CUSTOMER][NEUTRAL] I, uh, are, are you, are you in [PII] actually?
[AGENT][NEUTRAL] I am.
[CUSTOMER][NEUTRAL] Cause um, so I used to work, well, when I worked for TPA I, I became good friends with people at uh Saint Anthony's Hospital. I still stay in touch with them and um SSM Healthcare.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh. Uh-huh.
[CUSTOMER][NEUTRAL] Yeah, so I, I got a lot of friends that, you know, I own and, you know, and that bizarre.
[AGENT][NEUTRAL] Oh yeah.
[AGENT][POSITIVE] Oh wow.
[AGENT][NEUTRAL] Oh, yeah. Do you work from home?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] Um I do, yes, thank God.
[AGENT][POSITIVE] See, that's, that's wonderful.
[CUSTOMER][NEUTRAL] I, I can't, I wouldn't anymore since I've worked from home so long, that's all I can do, but, you know, I still, we've been working 50, 60 hours a week.
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][NEGATIVE] So I got yeah I got lucky getting the day off, so that's why I'm trying to do all this crap today since I'm off.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So, but yeah, I'll call [PII]'s here when I get off the phone with you and see what the heck's going on because since I'm off, I might just go by and pick them up.
[AGENT][POSITIVE] OK. All right, sounds good.
[CUSTOMER][POSITIVE] We will see how it goes, and I appreciate you and I hope you have a blessed day.
[AGENT][NEUTRAL] You too, uh, [PII].
[CUSTOMER][POSITIVE] All right, have a good one.
[AGENT][NEUTRAL] Go go cheeses.
[CUSTOMER][NEUTRAL] Yeah, next year.
[AGENT][NEUTRAL] Next year, maybe next year.
[CUSTOMER][POSITIVE] Thank you, yeah, rap on your ear. All right, bye-bye.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Have a good day. Bye-bye. Thanks for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.