AccountId: 011433970860
ContactId: 194d434f-3608-4a03-945c-7ebcf326a8fc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 3443879 ms
Total Talk Time (AGENT): 815873 ms
Total Talk Time (CUSTOMER): 1409379 ms
Interruptions: 7
Overall Sentiment: AGENT=0, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/194d434f-3608-4a03-945c-7ebcf326a8fc_20250129T14:58_UTC.wav
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[AGENT][NEUTRAL] Good Morning, thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hey [PII], how are you?
[AGENT][NEUTRAL] I'm fine. How are you?
[CUSTOMER][NEUTRAL] I'm good I'm good uh I was trying to get some information on some claims that I submitted, um, and get a little bit more information on this, uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] May I ask who's calling?
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] This is uh [PII].
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected, I can call you back?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have your policy number?
[CUSTOMER][NEUTRAL] I do. I am trying to.
[CUSTOMER][NEUTRAL] OK, so my, it looks like my policy number is 25.
[CUSTOMER][NEUTRAL] 377-52.
[AGENT][NEUTRAL] Thank you, hold on one moment please.
[AGENT][NEUTRAL] And what's your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And can I verify your address and email address, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your email address?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] And how did you pronounce your last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, Mr. [PII].
[AGENT][NEUTRAL] And you had some questions about some claims?
[CUSTOMER][NEUTRAL] Uh, yes, so I just submitted, so, um.
[CUSTOMER][NEUTRAL] The let me see what date was this? I'm trying to find it. OK, so um.
[CUSTOMER][NEUTRAL] [PII] I resubmitted a a claim.
[CUSTOMER][NEUTRAL] But the thing is, uh, I'm trying to view the files that up.
[CUSTOMER][NEUTRAL] And upload it, bear with me. It's a couple claims that I submitted, right? so.
[CUSTOMER][NEUTRAL] Um, that claim that I submitted was updated charges, right? So it, it did not include.
[CUSTOMER][NEUTRAL] Uh, everything, so they put a note that says the above reference claim appears to be a duplicate previously submitted, which is not the case. It's the updated total charges.
[CUSTOMER][NEUTRAL] Um, and then also, uh.
[CUSTOMER][NEUTRAL] It, it, it's, it's kind of weird. It, it's a, it's a client for both me and my son they put it all on 11 sheet, um.
[CUSTOMER][NEUTRAL] But I had um.
[CUSTOMER][NEUTRAL] Uh, like a procedure done and then my son had a procedure done as well, but, uh, I.
[CUSTOMER][NEUTRAL] It, it's, it's weird because um I went to the and there's another claim where I went to the urgent care.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] That claim wasn't paid out in full and then also they they said something about the office visit but both of these were were procedures that were done.
[CUSTOMER][NEUTRAL] So I'm not uh.
[AGENT][NEUTRAL] OK. On, on you, what date of service was it for?
[CUSTOMER][NEUTRAL] OK, so, um, if, if we're looking at that one claim, um, let's see, I just resubmitted it, so 126.
[CUSTOMER][NEUTRAL] Right, uh, that date of service for me, um, I'm pulling that up.
[CUSTOMER][NEUTRAL] On the computer that date of service was [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And it was 10
[CUSTOMER][NEUTRAL] [PII] as well for my son as well.
[AGENT][NEUTRAL] OK, hold on just a moment, let me try to pull up the claim.
[CUSTOMER][NEUTRAL] So, so the check that they sent for the [PII] something, I didn't, I didn't, I didn't cash that check, um.
[CUSTOMER][NEUTRAL] I didn't deposit that check. I, I still have that sitting here because uh it was I didn't get the full total charges so if you, if you look at that image it it shows me right? and then it shows um.
[CUSTOMER][NEUTRAL] My, my, my charges is 2216.
[CUSTOMER][NEUTRAL] Plus the 3:41.
[AGENT][NEUTRAL] Hold on just a moment, let me get the claim up.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, I'm looking at the first page on the first claim that you sent in.
[AGENT][NEUTRAL] For 10-11, the provider was [PII].
[CUSTOMER][NEUTRAL] Which one what's the
[AGENT][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Uh, what, what's the claim number?
[AGENT][NEUTRAL] 353-576-8
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 68 let me see, OK, yep so this claim.
[CUSTOMER][NEUTRAL] Where they paid the 768, there were still charges that were pending, so they didn't.
[CUSTOMER][NEUTRAL] Um, give me one second, I, uh.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I'm opening that now. OK, so this one here.
[AGENT][NEGATIVE] Looks like everything was paid and denied on that claim.
[CUSTOMER][NEUTRAL] Yeah, so, um, but it wasn't the full amount like when I submitted that it was still another bill that was associated with that date of service.
[CUSTOMER][NEUTRAL] That's why, 00, [PII], uh, OK, so that's.
[CUSTOMER][NEUTRAL] The other one was the urgent care physician, uh.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] So that was, that was an urgent care visit. That wasn't like me going to see a doctor. I was, I was injured.
[AGENT][NEUTRAL] On, um, for this [PII]?
[CUSTOMER][NEUTRAL] Um, and.
[CUSTOMER][NEUTRAL] Uh, uh, no, 9:10.
[AGENT][NEUTRAL] 0, 1910.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] That's for 1011, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, the numbers are so close, right? uh.
[AGENT][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] [PII], that that was um.
[AGENT][NEUTRAL] OK, I see 9:10 for.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, [PII], that that was the urgent care visit. That was um.
[CUSTOMER][NEGATIVE] That that was me being injured.
[CUSTOMER][NEUTRAL] That wasn't like a uh a regular doctor's visit.
[CUSTOMER][NEUTRAL] And to my understanding when I talked to my, my, uh, my insurance, uh, the, the person who provides insurance, they said urgent cares are covered.
[CUSTOMER][NEUTRAL] So that was what people at urgent care.
[AGENT][NEUTRAL] Let me look at.
[AGENT][NEUTRAL] We look at [PII]. I was looking at [PII].
[CUSTOMER][NEUTRAL] Yeah, we could start from the very beginning so uh.
[CUSTOMER][NEUTRAL] [PII] is the first date.
[CUSTOMER][NEUTRAL] And um.
[CUSTOMER][NEUTRAL] That's, that's what Piedmont urgent care.
[CUSTOMER][NEUTRAL] Are you able to see the documents that I submitted?
[AGENT][NEUTRAL] Yes, I'm looking at the explanation of benefits. That's probably why we did not know it was an urgent care because it just has the doctor's name.
[AGENT][NEUTRAL] And say we, we, we did not know it was urgent care. Do you have a billing that you can send to us that has, that it is an urgent care?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, so the bill that I attached that showed.
[AGENT][NEUTRAL] Like an itemized bill.
[CUSTOMER][NEUTRAL] Yeah, the bill that I that I attached, uh, that shows the 239-17 is so I attached that and the explanation of benefits when I uploaded that claim.
[AGENT][NEUTRAL] The last time that you sent in?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me see if I
[CUSTOMER][NEUTRAL] The the uh
[CUSTOMER][NEUTRAL] Yeah, so, uh, it's, it's so many windows. I'm so sorry. I'm trying to navigate and I get all these documents.
[AGENT][NEUTRAL] That's what, yeah, I'm looking at trying to look at 25 pages while I'm talking to you. It's like, OK, hold on. But yeah, we'll, we'll get there though.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, we'll get there. OK, so yeah, so if you look at the PUC bill one and then um and and that's the backside.
[AGENT][NEUTRAL] Is that the one that was denied as a duplicate that you sent in showing it was urgent care?
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] OK, hold on, let me get that claim pulled up.
[CUSTOMER][NEUTRAL] So that that one there is it didn't.
[CUSTOMER][NEUTRAL] 866.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] And and I'm not sure if they see the adjustment because.
[CUSTOMER][POSITIVE] You know, I have a high deductible plan. Like all this stuff is, it's, it's crazy. I didn't know I was on a high deductible plan, but I, I'm so grateful that I got the gap insurance, right.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Hold on just a moment. I'm sorry. I'm trying to look at all of it.
[AGENT][NEUTRAL] Right
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] 111.
[AGENT][NEUTRAL] T
[AGENT][NEUTRAL] So on the [PII], we paid the 8953.
[CUSTOMER][NEUTRAL] Yeah, and I don't even know where where that 8953 came from because the X-ray was a 100.
[AGENT][NEUTRAL] It's
[CUSTOMER][NEUTRAL] And $24 and
[AGENT][NEUTRAL] Yeah, the, uh, X-ray 8953 was applied to the deductible.
[AGENT][NEUTRAL] That's where we got the 8953. They did an X-ray on [PII].
[AGENT][NEUTRAL] For Calero and 8953 went the deductible.
[CUSTOMER][NEUTRAL] Yeah, yeah, I, I, yep.
[CUSTOMER][NEGATIVE] How does that, how does that work? They don't pay it in full.
[AGENT][NEUTRAL] No, this policy coordinates with your primary insurance. Whatever is applied to your deductible copay or co-insurance on your primary EOB, that's all we pick up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So like they charge 124. 38?
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Only 8953 was applied to the deductible.
[CUSTOMER][NEGATIVE] Oh, so, so essentially they just overcharged it.
[AGENT][NEUTRAL] Right, so.
[AGENT][NEUTRAL] They allowed
[AGENT][NEUTRAL] Um, 8953 and applied 8953 to the deductible and that's what we paid.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So they should have
[CUSTOMER][NEGATIVE] Because I got a bill now.
[AGENT][NEUTRAL] Written off 3485 on that one X-ray now, it's broken down each procedure code, so.
[CUSTOMER][NEUTRAL] 298
[AGENT][NEUTRAL] The office visit was 25568.
[AGENT][NEUTRAL] Which if it is an urgent care, then.
[AGENT][NEUTRAL] We would have pay, also paid the 20 364, but not knowing it was an urgent care, we didn't pay the office visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If you want you can just kind of like I had I did not cash this check that was sent out so um if you just wanna void that check and then we just kind of.
[CUSTOMER][NEUTRAL] Accumulate everything and go line by line or if you just wanna.
[CUSTOMER][NEUTRAL] Do that because so what what you're saying is that the policy would have paid 20364.
[AGENT][NEUTRAL] Right. Uh, you said it was for an urgent care?
[CUSTOMER][NEUTRAL] Towards that
[CUSTOMER][NEUTRAL] It was, it was, and you could see it on there.
[AGENT][NEUTRAL] Well
[CUSTOMER][NEUTRAL] It's from Piedmont urgent care, so.
[AGENT][NEUTRAL] P
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] Spell that for me, I'm sorry.
[CUSTOMER][NEUTRAL] P U C
[CUSTOMER][NEUTRAL] Uh [PII] I E D M [PII] N T.
[AGENT][NEUTRAL] Piedmont urgent care.
[CUSTOMER][NEUTRAL] And then urgent care.
[CUSTOMER][POSITIVE] And what's funny is that I designed a lot of Piedmont urgent cares.
[CUSTOMER][NEUTRAL] I probably did like over 35 of them.
[CUSTOMER][NEUTRAL] In my profession, but
[AGENT][NEUTRAL] Yeah, we would have got an actual bill that said urgent care, then we would have paid it as an urgent care.
[AGENT][NEUTRAL] But see, on the explanation of benefit, it only shows provider name.
[AGENT][NEUTRAL] So we don't know that he works in the urgent care.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But I'll get this claim reviewed and if we need anything else, I'll give you a call back. If not, I'll go ahead and process it for the 20364.
[CUSTOMER][POSITIVE] OK, OK, great.
[AGENT][POSITIVE] But you can go ahead and cash that check. That check is good.
[CUSTOMER][NEUTRAL] And then uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I'll, I'll call, I'll call [PII] to talk to them about the remaining balance, um, so that's that, and then, OK, so now we could discuss.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, where was it? It's just.
[CUSTOMER][NEUTRAL] So this one here, yep, so.
[CUSTOMER][NEUTRAL] The 1011
[CUSTOMER][NEUTRAL] Um, the 1011.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I have those were incoming bills, right? So that if you look at, let me see which claim that was so I submitted two separate ones, one for my son and one for me.
[CUSTOMER][NEUTRAL] So let me take a look and see.
[AGENT][NEUTRAL] And we're still looking at yours for 1011 or your son's?
[CUSTOMER][NEUTRAL] Yeah, we, we, we could look at mine for 1011, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me make sure I'm looking at the right claim number real quick. OK, yes, so claim number, um, that ends in 761 that I just submitted.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So uh for me.
[CUSTOMER][NEUTRAL] I have that that was a procedure. I had, I had like uh a minor, a minor surgery.
[CUSTOMER][NEUTRAL] That day
[CUSTOMER][NEUTRAL] So, um.
[CUSTOMER][NEUTRAL] You know I got uh 32581 balance and then I got a 556 54 balance so they came in separately so I submitted that claim before the total charges came in.
[AGENT][NEUTRAL] Let's see, let me go back to this one.
[AGENT][NEUTRAL] OK. For 1011.
[AGENT][NEUTRAL] I have pathology.
[AGENT][NEUTRAL] For [PII].
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] So we didn't pay anything on that one claim that you sent the 3 761. Let me look at the other claim number.
[CUSTOMER][NEUTRAL] Yeah, because I think what they said was duplicate claim or something like that.
[AGENT][NEUTRAL] OK, we paid the 163. No, wait a minute, that's not it. Let me find.
[AGENT][NEUTRAL] 24532.
[AGENT][NEUTRAL] OK. This was a procedure, a lesion. Is that the one you're talking about?
[CUSTOMER][NEUTRAL] Uh, correct, uh, let's see.
[AGENT][NEUTRAL] Yes, and we paid 24532.
[CUSTOMER][NEUTRAL] Uh, let's see, so 2.
[AGENT][NEUTRAL] That was on the check with your 19-0.
[CUSTOMER][NEUTRAL] Yes, so I see that and that that procedure was like uh I'm trying to see so.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] So they paid that and then they paid um because because it all shows [PII] right and then it shows 107 58.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] 58, that's another procedure.
[CUSTOMER][NEUTRAL] And 163.
[AGENT][NEUTRAL] And we pay the lab for 163 43.
[CUSTOMER][NEUTRAL] The 162.
[AGENT][NEUTRAL] And then we paid another lab for 16238.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Oh, OK, so the the 162 and 163 are the two labs. So let me, let me do some quick math real quick. 162.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] 162.43 + 162.38.
[CUSTOMER][NEUTRAL] So that paid that that OK so.
[CUSTOMER][NEUTRAL] That covered
[CUSTOMER][NEUTRAL] That deal and then.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Then we paid the 107 for another biopsy of the skin.
[AGENT][NEUTRAL] 107 58.
[CUSTOMER][NEUTRAL] Um, wait, uh, so I, I see the pathologist and then.
[CUSTOMER][NEUTRAL] Then I see um.
[CUSTOMER][NEUTRAL] So what they did was uh.
[CUSTOMER][NEUTRAL] OK, so there's 2, there's 2 owners.
[CUSTOMER][NEUTRAL] 00 OK so you guys only paid for the stuff under.
[CUSTOMER][NEUTRAL] [PII], right? That's the bill that you guys get, right?
[AGENT][NEUTRAL] Right, the EOB that we have shows [PII] and those amounts that was applied to the deductible.
[CUSTOMER][NEUTRAL] OK, and there's a, a [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh, that did the actual surgery.
[AGENT][NEUTRAL] Hold on just a second.
[CUSTOMER][NEUTRAL] And, and then
[AGENT][NEUTRAL] I see [PII], I see.
[CUSTOMER][NEUTRAL] I have a
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] I see [PII].
[CUSTOMER][NEUTRAL] Yeah, so that this one here.
[AGENT][NEUTRAL] Let's see, [PII], trying to look at all the pages on this first claim.
[AGENT][NEUTRAL] Let's see [PII] again.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Yeah, so you guys don't have any of the [PII].
[AGENT][NEUTRAL] No, we do not. I don't see [PII].
[AGENT][NEUTRAL] All I see is [PII].
[CUSTOMER][NEUTRAL] So that's that's what I.
[CUSTOMER][NEUTRAL] That's what I submitted in this last claim of 761.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me look at that then.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] And it's still tied to the same, uh, explanation of benefits.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Trying to get that bill to come up.
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] OK, I see the bill that has [PII]'s name on it, but I
[AGENT][NEUTRAL] Don't see the EOB with her name on it.
[CUSTOMER][NEUTRAL] Uh, if you go back to that first claim that I submitted, uh, it, it should have the EOB.
[CUSTOMER][NEUTRAL] Um, attached with that, uh.
[AGENT][NEUTRAL] The one that we paid on?
[CUSTOMER][NEUTRAL] The one you guys paid on, so I'm opening up the explanation of benefits and.
[CUSTOMER][NEUTRAL] Um, that document has the explanation of benefits for that visit, so.
[CUSTOMER][NEUTRAL] I see the
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I opened up the explanation of benefits so.
[CUSTOMER][NEUTRAL] This is for the stances, uh, OK, so.
[CUSTOMER][NEUTRAL] That's taken care of and then.
[CUSTOMER][NEUTRAL] The lab that's taken care of and if you come down you see the Jessica Mercer right so it's the.
[AGENT][NEUTRAL] Hold on just a second. Let me get that back up.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] That was for the 353-5768.
[CUSTOMER][NEUTRAL] Uh, do you mean the claim number?
[AGENT][NEUTRAL] Yes, sir. That, OK, let me.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, yep, yep.
[CUSTOMER][NEUTRAL] That shows the [PII] one, right? um.
[AGENT][NEUTRAL] I thought I looked at all of those and they were all [PII].
[CUSTOMER][NEUTRAL] Because this was a
[CUSTOMER][NEUTRAL] The 2:45.
[CUSTOMER][NEUTRAL] Was applied the 245 32 was applied.
[CUSTOMER][NEUTRAL] And then they
[AGENT][NEUTRAL] Let's see. I'm on page 9 of claim number 353-5768.
[AGENT][NEUTRAL] EOB, I see [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh, yeah, I'm still kind of going through it, so if you go through [PII] and then there's the.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh, hold on, um.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEGATIVE] That's nothing. That's nothing, that's nothing.
[AGENT][NEGATIVE] That's nothing, that's nothing.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, OK then let me generate a new um.
[AGENT][NEUTRAL] Yeah, I don't see the [PII] EOB.
[CUSTOMER][NEUTRAL] EOB.
[CUSTOMER][NEUTRAL] OK, so let me, let me generate.
[AGENT][NEGATIVE] It shouldn't have been done as a duplicate. It should have been asking for the explanation of benefit for [PII].
[AGENT][NEUTRAL] That's what I'm saying.
[CUSTOMER][NEUTRAL] Surprisingly they put it both under [PII], um, I see.
[CUSTOMER][NEUTRAL] Yeah, let me, let me click on this and then let me open up explanation of benefits.
[AGENT][NEUTRAL] Yeah, it should be an EOB that has [PII]'s name in the provider section.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, [PII]. No, it's the same document. They did not.
[CUSTOMER][NEUTRAL] Um, they, they did not separate it, but they do have the total amounts, the 32581.
[CUSTOMER][NEUTRAL] And then the
[CUSTOMER][NEUTRAL] 556 they just put it under [PII] that's all that they did.
[CUSTOMER][NEUTRAL] They put it under [PII] versus um [PII].
[AGENT][NEUTRAL] Uh, yeah, I see [PII]'s name on the bill you sent, but I just didn't see the.
[AGENT][NEUTRAL] Explanation of benefits.
[CUSTOMER][NEUTRAL] So there's a 556 54.
[AGENT][NEUTRAL] Usually they
[AGENT][NEUTRAL] Usually they break it down for each provider.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You may want to call your primary insurance and ask them if there's an explanation of benefits for [PII].
[CUSTOMER][NEUTRAL] They, they do.
[CUSTOMER][NEUTRAL] Well, it's not, I didn't deal with [PII]. I, I dealt with [PII], so.
[AGENT][NEUTRAL] [PII]. Oh.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So your primary put it under [PII].
[CUSTOMER][NEUTRAL] That's why I'm I'm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But the bill lines up, uh, the amounts and what they billed for.
[AGENT][POSITIVE] Lines up with everything for [PII].
[CUSTOMER][NEUTRAL] Uh, the, the, the top.
[AGENT][NEUTRAL] That's why they did it as a duplicate then because it was already paid under [PII]'s name.
[CUSTOMER][NEUTRAL] Uh, yeah, the first part was paid under [PII].
[AGENT][NEUTRAL] Because the
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] But, but the second part, uh, the 556 was, was not.
[CUSTOMER][NEUTRAL] And that was that was that was a procedure.
[CUSTOMER][NEUTRAL] And I don't know why they have the same date because uh.
[CUSTOMER][NEUTRAL] You know, the, the biopsy.
[CUSTOMER][NEUTRAL] And, and, and, and, uh, the surgery we're not on the same date.
[AGENT][NEUTRAL] Yeah, so all of them showing [PII].
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So are they able to reprocess it?
[CUSTOMER][NEUTRAL] For the 556.
[AGENT][NEUTRAL] OK, where, where's the 556? I don't see.
[CUSTOMER][NEUTRAL] Uh, it's under [PII]. It's on, um, page 4 of 9.
[AGENT][NEUTRAL] 4.
[AGENT][NEUTRAL] Hold on, what claim number are you on?
[CUSTOMER][NEUTRAL] Um, it
[CUSTOMER][NEUTRAL] It's uh give me one second so the client it was the one that was.
[CUSTOMER][NEUTRAL] Denied as a duplicate claim so what what number was this?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] This claim number is uh 7 it ends in 7.
[AGENT][NEUTRAL] 35368.
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] 761
[AGENT][NEUTRAL] 761.
[CUSTOMER][NEUTRAL] Yeah, the comment that they put was, uh, the above reference claim appears to be a duplicate previously submitted.
[AGENT][NEUTRAL] OK, and what page were you looking at? 9?
[CUSTOMER][NEUTRAL] Uh, 4 of 9.
[AGENT][NEUTRAL] 4.
[CUSTOMER][NEUTRAL] Well, it starts on 3, right? So it has the.
[CUSTOMER][NEUTRAL] Um, [PII] and then it goes into um.
[AGENT][NEUTRAL] OK, I have claim number 353-5768 and it has 25 pages.
[CUSTOMER][NEUTRAL] The amounts
[AGENT][NEUTRAL] Is that the one you're looking at?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mm, this one has 9 page the explanation of benefits has 9 pages, um, but the claim number.
[CUSTOMER][NEUTRAL] So the claim number is 3556761.
[AGENT][NEUTRAL] OK, 3556761.
[AGENT][NEUTRAL] 968.
[AGENT][NEUTRAL] I know I.
[AGENT][NEUTRAL] Hold on one moment. Let me see. I don't see that one.
[AGENT][NEUTRAL] For that claim number, I only see the that bill that we were looking at.
[AGENT][NEUTRAL] It has all the [PII] on it.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] 000 yes, yes, uh, if you go back to the explanation of benefits that was submitted, uh, on the first one, if you go to page 9 or or page 4.
[AGENT][NEUTRAL] 355, I mean, 353.
[CUSTOMER][NEUTRAL] Yeah yeah yeah.
[AGENT][NEUTRAL] 5768.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] So on their
[CUSTOMER][NEUTRAL] On there it uh it starts on the 3rd 3rd page is is where it starts to build uh.
[CUSTOMER][NEUTRAL] It says [PII] and then it goes through like the 203245.
[AGENT][NEUTRAL] OK, the one I'm looking at for that claim number, hold on just a second, let me do something else, pull up that mail number.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] What I can do is I can submit a new claim if you like and just attach the two items.
[AGENT][NEUTRAL] That would probably be the easiest.
[CUSTOMER][NEUTRAL] Highlighting
[AGENT][NEUTRAL] You said uh page, OK. I see 15 pages on this one, lesion on foot and skin conditioning test.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] Uh, that was the surgery, so here, actually what I will do is I, I will do this. I will submit a new claim and this will just make things so much easier, right? And um I have the, so I'm gonna.
[AGENT][NEUTRAL] Hm, let's see.
[CUSTOMER][NEUTRAL] When I submit it you see it right away, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, OK, so let me.
[AGENT][NEUTRAL] When you upload it to the online service center.
[CUSTOMER][NEUTRAL] Let me do this, so I'm gonna submit that and then um let me come to my download explanation of benefits.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, United Healthcare now wants to act up.
[CUSTOMER][NEUTRAL] Alright, so, um.
[CUSTOMER][NEUTRAL] Explanation of benefits.
[CUSTOMER][POSITIVE] I'm gonna download this right now.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Download that
[CUSTOMER][NEUTRAL] And then I'm going to.
[CUSTOMER][NEUTRAL] Upload that so.
[CUSTOMER][NEUTRAL] It is, it says submitting so OK there it goes, uh.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Not sure what's going on with the website, but it it it.
[CUSTOMER][NEUTRAL] Maybe attaching these items.
[CUSTOMER][NEUTRAL] But this, this will be for um.
[CUSTOMER][NEUTRAL] The lower portion of it, uh, it, it because I guess the.
[CUSTOMER][NEUTRAL] The the claim for just commercial was paid but not for [PII].
[CUSTOMER][NEUTRAL] I'm just waiting on the website now to uh to update uh.
[AGENT][NEUTRAL] What amount were you talking about for [PII]? What was the total amount? Do you remember?
[CUSTOMER][NEUTRAL] 556 54.
[AGENT][NEUTRAL] 5654.
[CUSTOMER][NEGATIVE] Yeah for some reason it's not allowing me to.
[CUSTOMER][NEUTRAL] To, uh,
[CUSTOMER][NEUTRAL] I wonder if it's because I have a photo.
[CUSTOMER][NEUTRAL] Um, OK, let me, let me remove.
[AGENT][NEUTRAL] Yeah, photo probably takes a long time to upload.
[CUSTOMER][NEUTRAL] Because it just says it stays at the submitting.
[CUSTOMER][NEUTRAL] Phase
[CUSTOMER][NEUTRAL] Um, I'm trying to submit it. Can I email it to you?
[AGENT][NEUTRAL] We normally don't accept emails because our email is not secure enough.
[AGENT][NEUTRAL] For claims.
[CUSTOMER][NEUTRAL] OK, and I, I.
[CUSTOMER][NEUTRAL] Uh, OK, so I, I'm submitting that, but um if you look at uh what the, the file that I just uploaded on the [PII] and you look at the bottom part for um like if you go down it says uh claim number 4947342 provider [PII].
[AGENT][NEUTRAL] OK. What was the claim number again?
[CUSTOMER][NEUTRAL] Bagos um.
[CUSTOMER][NEUTRAL] Uh, it's their claim number. It's not, um.
[AGENT][NEUTRAL] Oh, OK. I can't pull that up then.
[CUSTOMER][NEUTRAL] But if you look at the claim that I just submitted, uh, the other day, uh,
[CUSTOMER][NEUTRAL] And click on that image.
[AGENT][NEUTRAL] Hold on just a second, let me see.
[CUSTOMER][NEUTRAL] You'll see uh.
[AGENT][NEUTRAL] Oh, I see where somebody put Piedmont urgent care now. Hold on just a second.
[AGENT][NEUTRAL] For 9:10. I didn't see that one a while ago.
[AGENT][NEGATIVE] I'm not sure why they didn't go back and pay that one since it said urgent care.
[AGENT][NEUTRAL] They just did it as a duplicate.
[AGENT][NEUTRAL] Yeah, the 293-17. I see that Piedmont urgent care bill now.
[AGENT][NEUTRAL] For the 9:10.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For 9:10 right.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] And it still say submitting.
[AGENT][NEUTRAL] It may take it a minute.
[CUSTOMER][NEUTRAL] But uh
[CUSTOMER][NEUTRAL] You just resubmitted that right so they'll update that for the 203-64 and I'll call, I'll call them and try to talk to them.
[CUSTOMER][NEUTRAL] But yeah, did the West I still say this.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Submitting
[CUSTOMER][NEUTRAL] Yeah, I, I'm not sure what's going on there, but, um, I'm trying to submit this.
[CUSTOMER][NEUTRAL] Disclaim, but um if you wanna look at my son's in the meantime.
[CUSTOMER][NEUTRAL] So I submitted the hospital bill that I received.
[CUSTOMER][NEGATIVE] And they didn't pay anything on that at all.
[AGENT][NEUTRAL] Hold on just a second, let me shut all yours down before I pull his up.
[CUSTOMER][POSITIVE] OK, yeah, we could just kind of come back to mine in a couple of minutes.
[AGENT][NEUTRAL] I guess my system's not moving at the moment. I'm sorry about that.
[CUSTOMER][NEUTRAL] That's no problem, I mean.
[AGENT][NEUTRAL] Not letting me shut them down.
[CUSTOMER][NEUTRAL] Mine is doing the same thing. It just, it says submitting.
[AGENT][NEUTRAL] It's like it's just sitting here.
[AGENT][NEUTRAL] Why?
[CUSTOMER][NEUTRAL] Maybe if I start to close out some of some of this stuff it might.
[AGENT][NEUTRAL] That's what I was trying to do, but it's not letting me shut it, close it.
[CUSTOMER][POSITIVE] Move a little faster.
[AGENT][NEGATIVE] It's not moving.
[AGENT][NEUTRAL] OK, so on here, let me see if I can get it pulled up.
[AGENT][NEUTRAL] Is it Eagleston Hospital?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Yep, so, um, they, they said, OK, the charges submitted are not payable because the service, OK, I can understand that for the [PII], right? So, um.
[CUSTOMER][NEUTRAL] Uh, [PII], right, so the.
[CUSTOMER][NEUTRAL] Radiologist I understand.
[AGENT][NEUTRAL] 827 24 ER.
[AGENT][NEUTRAL] For the ER?
[CUSTOMER][NEUTRAL] Um, I will.
[CUSTOMER][NEUTRAL] Yes, we, we can start off there, right, so [PII] well the.
[CUSTOMER][NEUTRAL] Let me, let me see, uh, I just had it in front, OK, yep, so.
[CUSTOMER][NEUTRAL] 827 we got a bill for um.
[CUSTOMER][NEUTRAL] We get
[CUSTOMER][NEUTRAL] Like 3800 and then we get 500.
[CUSTOMER][NEUTRAL] For [PII] and then.
[CUSTOMER][NEUTRAL] [PII] we got 980 and and then.
[CUSTOMER][NEUTRAL] Um, on [PII], we got another 4.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you said the EOBs and all that for those?
[CUSTOMER][NEUTRAL] Uh yes.
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] Because the EOB is just like uh a running list.
[AGENT][NEUTRAL] I see a bill with the broken down charges, but I don't see the EOBs.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Should I try like Internet Explorer? because this thing still says submitting.
[AGENT][NEUTRAL] Um, that I'm not sure.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, they, they looks like they asked for diagnosis codes and EOBs for on your son.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, please provide copies in order to, OK.
[CUSTOMER][NEUTRAL] I can resubmit here. Let me, let me try Internet Explorer real quick.
[CUSTOMER][NEUTRAL] And and see if this works out better for submitting the claim because this.
[CUSTOMER][NEGATIVE] Doesn't seem to.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Bear with me.
[CUSTOMER][NEUTRAL] OK, here we go, uh, got it.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So let me see if it allows me to upload a claim.
[CUSTOMER][NEUTRAL] What I'm gonna do is, uh, let me select.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] These files for my son, um.
[CUSTOMER][NEUTRAL] I, I don't know, maybe, uh, Internet Explorer may work.
[CUSTOMER][POSITIVE] Better, oh yeah, OK. Internet Explorer seems to be working better.
[CUSTOMER][NEUTRAL] Um, attach that file and then let me.
[CUSTOMER][NEUTRAL] Attached to back
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Cool, uh, see this stuff I'm submitting.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][NEUTRAL] Oh wait, oh boom, OK, so but shes just went through, so let me close out the.
[CUSTOMER][NEUTRAL] OK, so I just submitted a claim for Bashir.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] And you should.
[CUSTOMER][NEUTRAL] You should see that now.
[AGENT][NEUTRAL] I can't see it yet. It hasn't come through.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So this shows the 118 charges, right?
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Hold on one moment, let me see.
[CUSTOMER][NEUTRAL] OK, so I'm going to do another one for him as well. um, let me go to
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Member [PII] apply.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] That's 118 right? so.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] 827.
[CUSTOMER][NEUTRAL] Explanation of benefits.
[CUSTOMER][NEGATIVE] I don't know why they just don't um include everything all.
[CUSTOMER][NEUTRAL] All together right.
[CUSTOMER][NEUTRAL] It it's so weird because they did mine like all together but they did not uh.
[AGENT][NEUTRAL] I don't understand. It's not, let me pull up that claim.
[CUSTOMER][NEUTRAL] Alright, so
[CUSTOMER][NEUTRAL] Alright, and then.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] And then I just submitted one for.
[CUSTOMER][NEUTRAL] So I did 8:27, I did 11 8.
[CUSTOMER][NEUTRAL] And then I guess I have to do.
[AGENT][NEUTRAL] Let's see, 8:27.
[AGENT][NEUTRAL] And 11 8, yeah. We need the 118, we need the facility and the physician, the emergency room physician charge.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So you, uh, so.
[CUSTOMER][NEUTRAL] 8:27.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yep, [PII], yep, you're right for 11 8.
[CUSTOMER][NEUTRAL] It's so weird because.
[CUSTOMER][NEUTRAL] I have, I have some other bills like individual bills.
[CUSTOMER][NEUTRAL] Let me see.
[AGENT][NEUTRAL] And we also need the diagnosis code for those dates as well.
[CUSTOMER][NEUTRAL] That are just kind of
[CUSTOMER][NEUTRAL] That's inside the explanation of benefits, right?
[AGENT][NEUTRAL] It's not on the explanation of benefits usually.
[AGENT][NEUTRAL] It's gonna be on a bill.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So I submitted
[CUSTOMER][NEUTRAL] The bill that I have.
[CUSTOMER][NEUTRAL] From children's and then also um the explanation of benefits.
[AGENT][NEUTRAL] Right. The diagnosis code is not usually on that bill or the explanation of benefits.
[AGENT][NEUTRAL] Most of the time, you have to call them and ask, tell them you need something has, that has the diagnosis code on it.
[CUSTOMER][NEUTRAL] Really? I have to provide all that? I have to call them to get that because uh they have the the processing code number.
[AGENT][NEUTRAL] Right, mhm.
[CUSTOMER][NEUTRAL] On here
[CUSTOMER][NEUTRAL] Uh, yeah, so, oh yeah, details, so if, if you go down further it shows the.
[CUSTOMER][NEUTRAL] The the codes.
[CUSTOMER][NEUTRAL] Like on on page 5.
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] 6
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Yeah, um, starting on page 3 processing claim processing codes.
[AGENT][NEUTRAL] Yeah, it says emergency room.
[AGENT][NEUTRAL] But it doesn't have the diagnosis code.
[AGENT][NEUTRAL] So they did an X-ray of chest, so that would be a diagnostic test, but it doesn't have the actual reason he went to the emergency room. They're two different. What they do in the emergency room is the procedure code and what he was actually there for is the diagnosis code.
[CUSTOMER][NEUTRAL] OK, let me review this, um, because there's some other claims as well that's on here for explanation of benefits.
[CUSTOMER][NEUTRAL] For those dates, um.
[CUSTOMER][NEUTRAL] That are
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Oh yeah it's all in the same thing.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh, what is this page 5.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] So who do I call for that? Who do I need to call?
[AGENT][NEUTRAL] For the hospital bill, you would call the hospital and tell them you need a diagnosis code, something that has a diagnosis code on it, a bill that has a diagnosis code on it for that data service.
[CUSTOMER][NEUTRAL] And then I, I would submit that to you.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Uh, OK, for the hospital bills diagnosis code and what does my plan pay on that on that particular.
[AGENT][NEUTRAL] Emergency room.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Any benefits given over the phone is not a guarantee of payment. Um, outpatient, we pay $750 per calendar day.
[AGENT][NEUTRAL] Whatever your primary applies to the deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and that's it, uh.
[CUSTOMER][NEUTRAL] Doesn't cover anything else?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Only 750 on emergency.
[AGENT][NEUTRAL] Um, it, it applies to all outpatient services, any outpatient services.
[AGENT][NEUTRAL] Or anything done in a doctor's office or uh independent lab.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's all under one outpatient which is 750 per calendar day.
[CUSTOMER][NEUTRAL] Alright, so, um, I am opening.
[CUSTOMER][NEUTRAL] My explanation of benefits right now so that way.
[CUSTOMER][NEUTRAL] You can see them uh for.
[CUSTOMER][NEUTRAL] Uh, let's see, yeah, so.
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] So I'm, I'm attaching this new explanation of benefits.
[CUSTOMER][NEUTRAL] Before this was at [PII].
[CUSTOMER][NEUTRAL] Yep
[CUSTOMER][NEUTRAL] So I'm updating this second portion of the.
[CUSTOMER][NEUTRAL] Of the claim
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] For me for uh.
[CUSTOMER][NEUTRAL] The procedure I had
[CUSTOMER][NEUTRAL] That is with [PII] the 556 and it just submitted.
[CUSTOMER][NEUTRAL] Are, are you able to see that?
[AGENT][NEUTRAL] I don't think it's gonna let me because my system has stopped.
[AGENT][NEUTRAL] You submitted 2 for your son, right?
[CUSTOMER][NEUTRAL] Uh, yeah, so I just, I just submitted one, yep, I submitted two for my son, one for the [PII] and one.
[AGENT][NEUTRAL] And then one for you.
[CUSTOMER][NEUTRAL] Uh, yeah, 1 for me and 2 for my son.
[CUSTOMER][NEUTRAL] With 2 days of service for my son, so I'm gonna call the hospital and I'm gonna get the diagnostics code for.
[CUSTOMER][NEUTRAL] For those two dates of service.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's not letting me pull yours up because I don't know, I guess mine has, my system has stopped.
[AGENT][NEGATIVE] Probably gonna have to shut it down and start all over.
[CUSTOMER][NEUTRAL] That's no problem. Would, would you like to
[AGENT][NEUTRAL] I can call you back.
[CUSTOMER][NEUTRAL] Give me a call back.
[CUSTOMER][NEUTRAL] OK, can you call me right at [PII] in an hour? Is that possible?
[AGENT][NEUTRAL] Yes, sir. I'll call you at [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Perfect, thank you so much. Uh, do you have my direct number?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] Yes, yes, and we can just kind of pick up. So I, what I did was that that will give me time to call the hospital to get the diagnostics codes, but then I just resubmitted, um, the claim for me.
[CUSTOMER][NEUTRAL] For the 556, the surgery claim that I had.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, um, and I don't know why they billed the, um, the pathologist on the same day. That was not on the same day, it was, it was different dates.
[CUSTOMER][NEUTRAL] Um, so.
[CUSTOMER][NEUTRAL] That's that's something that.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][POSITIVE] And then on that same bill at the very top I'm gonna submit one more for my son who also had uh a surgery that that's just $124 looks like insurance took care of most of it and just left a $124 balance.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with right now?
[CUSTOMER][NEUTRAL] Uh, no, ma'am.
[AGENT][POSITIVE] Thank you, Mr. [PII], for calling APL. You have a good day and I'll call you back shortly.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Bye bye.