AccountId: 011433970860
ContactId: 1d1ec5b1-bc55-4a25-993f-6ff3cbe1e4ba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 5540859 ms
Total Talk Time (AGENT): 861840 ms
Total Talk Time (CUSTOMER): 2688229 ms
Interruptions: 8
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/1d1ec5b1-bc55-4a25-993f-6ff3cbe1e4ba_20250117T19:03_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I just wanted to check something out on a claim of mine if you could look that up for me.
[AGENT][NEUTRAL] Sure. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII] and my contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And Ms. [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] I don't have it pulled up right now. I can give you my social.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So I'm just waiting for the policies to come up here. Hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Here we go.
[AGENT][NEUTRAL] And Ms. [PII], can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] Yes, [PII], [PII] [PII] [PII].
[AGENT][NEUTRAL] All right and thank you so much for verifying your information and all the information provided is a verification of benefits, not a guarantee of payment. And for your claim status, um, do you have the date of service or would it be this most recent claim here?
[CUSTOMER][NEUTRAL] It's the most recent claim that was, uh, and it says it's processed and I got a deal in the mail saying they didn't think they needed any more information. They would let me know, but then I got a text saying the claim has actually been processed. Well, if it's been processed, it would be paid on though, right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It could be, let me see, I'm pulling it up now. Hold on one moment, I can see what the decision was.
[CUSTOMER][NEUTRAL] OK. Cause there's no reason that one should have been denied for anything. This is my immunotherapy, and it's a big one, and it's saying it paid $0.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] So it's a few reasons. Hold on one moment. Let me, do you mind if I place you on just a brief hold so I can go through the, the claim?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] What?
[AGENT][NEUTRAL] 447.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Lord.
[AGENT][NEUTRAL] Oh my [PII].
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] From PO with CPT.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] That's it? What's the terms of it?
[AGENT][NEUTRAL] OK, but what's the terms on it because I know she's gonna ask and I need to know.
[AGENT][NEUTRAL] Oh my [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] I see nothing about.
[AGENT][NEUTRAL] Intensive care writer.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hello Miss [PII].
[CUSTOMER][POSITIVE] Oh yes
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. So it looks like the claim was denied, but it was for a few reasons. Some needs additional information, but um let me give you
[AGENT][NEUTRAL] So one of the
[CUSTOMER][NEGATIVE] This is getting, this is getting very old because I put procedure codes. I did everything by the book. So what is it missing now?
[AGENT][NEUTRAL] So this is saying, um, the explanation of benefits is needed from the primary insurance for November.
[AGENT][NEUTRAL] I'm sorry. Yeah, for [PII].
[CUSTOMER][NEGATIVE] OK. They told me I specifically spoke with your department and they said the explanation of benefits would work or the thing that I sent. That's why I sent the thing that I sent. So obviously that wasn't correct.
[CUSTOMER][NEUTRAL] It was just the explanation you have to have?
[AGENT][NEUTRAL] So, the explanation of benefits and the itemized billing um with the procedure, the CPT code, the procedure codes and the charges from the physician's office.
[CUSTOMER][NEUTRAL] Do you have any of that on there? Is any of that on what I sent?
[AGENT][NEUTRAL] Um, let me see the documents. Hold on one moment.
[CUSTOMER][NEGATIVE] In fact, I can't wait another 6 weeks to get my money again. I mean, I have no job, ma'am, and I am living on my cancer, you know, I have to be paid.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] There's got to be a way of expediting or you guys helping me through Blue Cross to get this proper information. The thing with Blue Cross is, even after they file and if they go through y'all or whatever, they wait forever to send out their explanation of benefits, even though the claim's been processed.
[AGENT][NEUTRAL] Hm, let's see.
[CUSTOMER][NEGATIVE] I check it every day to see when it's there, and it may be there now, but it's been, I mean, weeks and weeks and weeks and still no explanation of benefits coming up on their website.
[AGENT][NEUTRAL] OK, and then what else is?
[CUSTOMER][NEUTRAL] I gotta be a simpler process to this, and this is crazy.
[AGENT][NEUTRAL] Well the.
[CUSTOMER][NEUTRAL] And I had to fight, fight, fight to get that from them, what I got. And then they were like, well, here, send them this, this will be sufficient. And I said, well, OK, so I sent that because that's all I had, because they did not have the explanation of benefits up even though their claim had already been processed and paid for.
[CUSTOMER][NEGATIVE] Which I, I don't understand why, how they can hold off on an explanation of benefits when they've already paid the claim. It doesn't make any sense to me.
[AGENT][NEUTRAL] Right, it should be, right.
[AGENT][NEUTRAL] Not that I understand because ours do come out, well, once the claim is processed, it's like automatic with it.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh, um,
[CUSTOMER][NEUTRAL] Where do I get this? What do I do? I mean, I've got to have this handled like ASAP.
[AGENT][NEUTRAL] So the only thing that we can do, so the explanation of benefits is needed, the itemized bill is needed, and then for the transportation benefit, the um facility address is needed.
[CUSTOMER][NEGATIVE] Yes, and I went round and round with them about that. This is ridiculous. They won't stamp the paperwork.
[CUSTOMER][POSITIVE] And my other at my [PII] Oncology one that I used to use through y'all, they just stamp it for me.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And they, every day, every time I would come, they'd get a big stamper out with their address. UT Southwestern doesn't do that, they said.
[CUSTOMER][NEUTRAL] So how do I get an address? Do I have to call the actual facility and reroute that as well?
[AGENT][NEUTRAL] Do you have like like discharge paper or like a a note from the facility that has the address on it?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] No, ma'am, they don't do that there. They don't give you anything when you check out at UT Southwestern, because I'm a cancer patient, I just go and everything's done and they do it only on my chart. They don't do anything in your hand when you leave.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I tried that too.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Is this, well, that's, that's a little.
[AGENT][NEUTRAL] I was thinking
[CUSTOMER][NEUTRAL] I'm more worried about my immuno benefit than I am my transportation right now. I can come back and refile that, but my immuno benefit is big, and I need that taken care of. And so for that, you're telling me I need an itemized bill with procedure codes as well as
[CUSTOMER][NEUTRAL] The and then how much longer are we looking again if I resend all this to you?
[AGENT][NEUTRAL] Well, let's see if
[CUSTOMER][NEUTRAL] And this is been waiting.
[AGENT][NEUTRAL] Let's see if we can.
[CUSTOMER][NEUTRAL] Sure a way you guys can do a three way with me my blueprint.
[AGENT][NEUTRAL] Once you can
[AGENT][NEUTRAL] Say that again.
[CUSTOMER][NEUTRAL] Is there a way you guys can three-way call me like some of my insurance companies do and say, get on the phone with them and say, hey, this is what she needs. Can you send this? or do something to make it a little more eas easily done, you know.
[AGENT][NEUTRAL] Like you need, um, like you're asking if you want to call the doctor and you speak with them?
[CUSTOMER][NEUTRAL] Yes, and say hey I need this sent to me. uh, could you do it that way? Would that make it any quicker and easier for me?
[AGENT][NEUTRAL] That's fine.
[AGENT][NEUTRAL] I mean, it might make it quicker in terms of uh or easier in terms of getting the documents, I hope. Um let me see what the facility, OK, this is the University of Texas.
[AGENT][NEUTRAL] OK, so
[AGENT][NEUTRAL] But we need it for 11:18.
[CUSTOMER][NEUTRAL] Pretty much all of this is through UT Southwestern in [PII].
[AGENT][NEUTRAL] Hold on one second.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Cause I'm just, I do see the explanation of benefits here. I'm just making sure.
[AGENT][NEUTRAL] Oh, but it's missing that date. OK, it's missing 11:18. I, I saw.
[CUSTOMER][NEGATIVE] And why would it be missing that date when that date was included in, and that's something they argued with me about. And they were like, nope, that date is included in it because I told her the day we were doing this, the lady at my insurance company, I said, I don't even see that date of service.
[CUSTOMER][NEUTRAL] And she said, no, ma'am, it's there. She said it's a group date. And she said it begins something like [PII]. They had a whole, I mean, um, yeah, I believe it was [PII] through the, a whole group of dates is the way she put it, and she said they grouped it together.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Because I see [PII], [PII].
[AGENT][NEUTRAL] And then it goes
[CUSTOMER][NEUTRAL] So why is that?
[AGENT][NEUTRAL] Say that again.
[CUSTOMER][NEGATIVE] I just don't understand why the main date where I got my infusion is missing, and UT Southwestern had to dig and hunt to even figure out that I'd had an infusion on that day.
[AGENT][NEUTRAL] Well, how are they doing their paperwork?
[CUSTOMER][NEGATIVE] That's what I'm not understanding, and I've got to get this fixed. This is getting detrimentally important for me.
[AGENT][NEUTRAL] OK, so for UT Southwestern, let me check this. I'm just making a list of everything, so I have it all in one place to um tell them.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm sorry. I just really don't know. I'm.
[AGENT][POSITIVE] No, you're totally fine. This is what we're here for. That's, you're not, it's not a problem at all.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, that was, and then what's this one, this is the itemized bill.
[AGENT][NEUTRAL] Yes, OK.
[CUSTOMER][NEUTRAL] And that was my daughter-in-law.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] Oh, this is the explanation of benefits from Blue Cross Blue Shield though. Do you have um UT Southwest's phone number? I can call them on [PII]. Did you want me to hold?
[CUSTOMER][NEUTRAL] Oh yes.
[CUSTOMER][POSITIVE] Uh, yes, hold on one second. I'll get it for you. Hey baby. Hey, come on, baby. I'll put your seat belt on, OK, sweetheart you cold.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Hang on, I'm sorry, I'm picking up my granddaughter. I'd be alright, we'll be right back. Y'all need anything for brochures? Dad? Oh yeah, give that to Mom, and there's her tea party. We can get it when you get back. It's patience is. OK. All right, let me, son. Bye. Alright, put that door, baby doll. How are you, love? OK, put your seatbelt on.
[AGENT][POSITIVE] Oh, you're totally fine.
[CUSTOMER][NEUTRAL] OK, I'm sorry, ma'am. I'm, I'm listening. Let me real quick.
[AGENT][POSITIVE] Oh, you're totally fine.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] UT so. Would you need the cancer care center where the infusion center where I actually have it done out?
[AGENT][NEUTRAL] Um, that's a good question. I don't know how it's broken up. Do you know if their billing is all the same, or I'm not sure about that.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I think you, I believe, I believe when with what? OK, sweetheart, just one second, baby. Cancer. Did you wear some flip flops? Good. OK.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sorry, I'm trying to pull them up for you. OK, here's the building that I go to.
[AGENT][NEUTRAL] No, you're fine.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the number is [PII].
[CUSTOMER][NEUTRAL] 645
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And that facility.
[CUSTOMER][NEUTRAL] It's called um
[CUSTOMER][NEUTRAL] The Cancer Care Outpatient building UT Southwestern.
[CUSTOMER][NEUTRAL] And the doctor that I see, if this would help me, is Doctor [PII].
[CUSTOMER][NEUTRAL] [PII] I believe [PII]
[CUSTOMER][NEGATIVE] If I'm spelling it right. There's a lot of doctors I see right now. And then, uh, as far as the billing, you may, when we get, when you call that number, you may ask for their billing department, but the problem is they get the billing department is like a mess.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm not lie. I tried to get through with somebody sometimes is rough.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well, we're gonna try. Um, do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] I about
[CUSTOMER][POSITIVE] Sure, thank you.
[AGENT][NEUTRAL] You're very welcome. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm. Hey baby. What you been doing? You are on hold.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] What?
[CUSTOMER][POSITIVE] Oh yes ma'am.
[AGENT][NEUTRAL] Hello, Ms. [PII].
[AGENT][NEUTRAL] Hey, let me make sure I have the number right. It sounds like a fax number. Um, was it [PII]?
[CUSTOMER][NEUTRAL] Let me make sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, make sure I didn't give you the fax number for some reason. That's what it says, [PII], but it doesn't say fax beside it, but maybe it is.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, let me try again. Um, hold on one moment, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Welcome to the UT Southwestern Simmons Comprehensive Cancer Center. If this is a medical emergency, hang up and call [PII]. If you are an established patient wanting to speak to your care team or wish to cancel or reschedule an appointment, press 1. If you are wishing to be seen as a new patient at Simmons Cancer Center, press 2. For billing questions, press 3. For copies.
[CUSTOMER][NEUTRAL] Please hold while your call is being transferred.
[AGENT][NEUTRAL] I got it.
[CUSTOMER][NEUTRAL] Good afternoon. Thank you for calling the account resolutions department at UT Southwestern. If you wish to make a payment or discuss your bill, press 1 to learn about UT Southwestern's financial assistance program or to discuss.
[CUSTOMER][NEUTRAL] The new or existing estimate, press 2. For attorney requests, press 3. If you are an insurance company, press 4. If you need to speak to me, we're sorry, our office is currently closed for lunch. Please call back after [PII] to speak to a representative.
[AGENT][NEUTRAL] Oh [PII].
[AGENT][NEUTRAL] OK, let me try another option.
[CUSTOMER][POSITIVE] We did it just right, didn't we?
[CUSTOMER][NEUTRAL] Now I will tell you this, I do have this other number that we could try I guess that it's a separate billing number that I found out about the other day from a guy that uh in the billing department. I think I saved it to my phone. Let me look at it and see if I can find it or not.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that was the only number that I was even halfway close to getting through to and that data service that we were talking about on the [PII]. OK, baby, just one second, they're not ready for us, honey they'd be about 8 minutes, they said, OK, just 8 more minutes. We can in just a minute. I'm on hold. OK, sweetie, just a minute, it won't be long. Be patient for just a little bit. All right, uh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I'm digging through looking.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I know it's called the billing department, I think. No telling what I saved it under is what I'm saying.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] No, I do know they also have a.
[CUSTOMER][NEUTRAL] The explanation of benefits when it does come up, it just hits that blue site portal or whatever, you know, that I'm always going through.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's where you don't see it at?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Right. That's it, it says coming soon, coming soon is all it ever says when you go on there. I had one that took 6 months to give me an explanation of benefits last year. And I was like, this is insane. I mean, you know, it can't be that long. They surely have a certain amount of time that they even have to do that, you know. OK, here's one of the numbers that he gave me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is the UT Southwestern customer service number for billing and it is [PII].
[CUSTOMER][NEUTRAL] 633
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alrighty, hold on one moment, OK?
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] True, thank you for calling the patient financial team at UT Southwestern regarding an estimated out of pocket cost for an upcoming service or financial assistance questions. Please hold for the next available representative. If you are calling regarding an open or outstanding balance for a past service, please press one to speak to our account resolutions department.
[AGENT][NEUTRAL] OK, I got it.
[CUSTOMER][NEUTRAL] If you would be willing to take a brief 3 question survey at the end of your call, please remain on the line after speaking with our representative to be transferred to the survey. Nobody is available to take your call at the moment.
[CUSTOMER][NEUTRAL] Hey, how are y'all?
[CUSTOMER][POSITIVE] Good. You wanna go pick out a color?
[CUSTOMER][NEUTRAL] Getting colder out there
[CUSTOMER][POSITIVE] you know you can pay your bill by phone through our automated. I have a UT Southwestern is a helpful tool where you can check your balance, pay your bill, or even select a flexible payment plan that your needs. Visit [PII] and click on MyChart to learn more.
[CUSTOMER][NEUTRAL] You can still ask the question
[CUSTOMER][NEUTRAL] Compassionate care and advanced medical thinking go hand in hand at UT Southwestern Medical Center, one of the world's top academic medical centers. We need specialties, several of which are ranked among the nation's best by US News and World Report. Visit [PII] to learn more.
[CUSTOMER][NEUTRAL] What's
[CUSTOMER][POSITIVE] We expenses are often more affordable for you. If you are having trouble paying your bill, be sure to ask our friendly flexible payment options and financial assistance. Do you want?
[CUSTOMER][NEUTRAL] Oh, and together
[CUSTOMER][POSITIVE] Maybe one of those, you know how you put that frosty stuff on like you did last time. That was really pretty. This is a pretty pink.
[CUSTOMER][NEUTRAL] Oh, that's not
[CUSTOMER][NEUTRAL] Wait, ask, do you want to ask mom if she wants to get a certain colors with them?
[CUSTOMER][NEUTRAL] Did you know you can pay your bills, click.
[CUSTOMER][NEUTRAL] Compassionate care and advanced thinking go hand in hand at UT Southwestern Medical Center, one of the world's top academic medical centers. We treat about 80 specialties, several of which are ranked among the nation's best by US News and World Report. Visit [PII] to learn more.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] We know medical expenses are often unexpected. For this reason, we created options to help make care more affordable for you. If you are having trouble paying your bills, be sure to ask our friendly team member about flexible payment options and our financial assistance program.
[CUSTOMER][NEUTRAL] Did you know you can pay your bills you can check your, your, or even selects. Visit [PII] and click on to learn more.
[CUSTOMER][NEUTRAL] I I'm asking
[CUSTOMER][NEUTRAL] Compassionate at UT Southwestern Medical Center, one of the world's top academic medical centers. We ranked among the nation's best by US News and World Report. Visit [PII] to learn more.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][POSITIVE] We know medical expenses are often unexpected. For this reason, we created options to help make care more affordable for you. If you are having trouble paying your bill, be sure to ask our friendly team member about flexible payment options and our financial assistance program.
[CUSTOMER][NEUTRAL] Hi [PII], how are you doing?
[CUSTOMER][NEUTRAL] Check with her mama she can get that color or not.
[CUSTOMER][NEUTRAL] I've been staying busy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Did you know you can pay your bill by phone through our new automated line? Do you have a UT Southwestern MyChart account? MyChart is a helpful tool where you can check your balance, pay your bill, or even select a flexible payment plan that meets your needs. Visit [PII] and click on MyChart to learn more.
[CUSTOMER][NEUTRAL] I wish
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Compassionate care and advanced medical thinking go hand in hand at UT Southwestern Medical Center, one of the world's top academic medical centers. We treat about 80 specialties, several of which are ranked among the nation's best by US News and World Report. Visit [PII] to learn more.
[CUSTOMER][POSITIVE] We know medical expenses are often unexpected. For this reason, we created options to help make care more affordable for you. If you are having trouble paying your bill, be sure to ask our friendly team member about flexible payment options and our financial assistance program.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEGATIVE] don't wanna be
[CUSTOMER][POSITIVE] It won't hurt
[CUSTOMER][NEUTRAL] Did you know you can pay your bill by phone through our new automated line? Do you have a UT Southwestern MyChart? is a helpful tool where you can check your balance, pay your bill, or even select a flexible payment plan that meets your needs. Visit [PII] and click on MyChart to learn more.
[CUSTOMER][NEUTRAL] Compassionate patient care and advanced medical thinking go hand in hand at UT Southwestern Medical Center, one of the world's top academic medical centers. We treat about 80 specialties, several of which are ranked among the nation's best by US News and World Report. Visit [PII] to learn more.
[CUSTOMER][POSITIVE] We know medical expenses are often unexpected. For this reason, we created options to help make care more affordable for you. If you are having trouble paying your bill, be sure to ask our friendly team member about flexible payment options and our financial assistance program.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Just didn't know what.
[CUSTOMER][NEUTRAL] You to see your daughter
[CUSTOMER][NEUTRAL] Did you know you can pay your bill by phone through our new automated line? Do you have a UT Southwestern MyChart? MyChart is a tool where you can check your balance, pay your bill, or even select a flexible plans. Visit [PII] and click on MyChart to learn more.
[CUSTOMER][NEUTRAL] Compassionate patient care and advanced medical thinking go hand in hand at UT Southwestern Medical Center, one of the world's top academic medical centers. We treat about 80 specialties, several of which are ranked among the nation's best by US News and World Report. Visit [PII] to learn more.
[CUSTOMER][POSITIVE] We know medical expenses are often unexpected. For this reason, we created options to help make care more affordable for you. If you are having trouble paying your bill, be sure to ask our friendly team member about flexible payment options and our financial assistance program.
[CUSTOMER][NEUTRAL] I promise, [PII] said tell [PII], hello.
[CUSTOMER][NEUTRAL] guess what? She likes a new job and one day she wants to take.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Did you know you can pay your bill by phone through our new automated line? Do you have a UT Southwestern MyChart account? MyChart is a helpful tool where you can check your balance, pay your bill, or even select the flexible payment plan that meets your needs. Visit [PII] and click on MyChart to learn more.
[CUSTOMER][NEUTRAL] Compassionate patient care and advanced medical thinking go hand in hand at UT Southwestern Medical Center, one of the world's top academic medical centers. We treat about 80 specialties, several of which are ranked among the nation's best by US News and World Report. Visit [PII] to learn more.
[CUSTOMER][POSITIVE] We know medical expenses are often unexpected. For this reason, we created options to help make care more affordable for you. If you are having trouble paying your bill, be sure to ask our friendly team member about flexible payment options and our financial assistance program.
[CUSTOMER][POSITIVE] are so good. You can tell your mommy you had a fancy book here.
[CUSTOMER][NEUTRAL] Did you know you can pay your bill by phone through our new automated line? Do you have a UT Southwestern MyChart account? MyCart is a helpful tool where you can check your balance, pay your bill, or even select a flexible payment plan that meets your needs. Visit [PII] and click on MyChart to learn more.
[CUSTOMER][NEUTRAL] Compassionate patient care and advanced medical thinking go hand in hand at UT Southwestern Medical Center, one of the world's top academic medical centers. We treat about 80 specialties, several of which are ranked among the nation's best by US News and World Report. Visit [PII] to learn more.
[CUSTOMER][POSITIVE] We know medical expenses are often unexpected. For this reason, we created options to help make care more affordable for you. If you are having trouble paying your bill, be sure to ask our friendly team member about flexible payment options and our financial assistance program.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] get in here. My friend said I didn't get much here of the snow.
[CUSTOMER][NEUTRAL] We got 3 inches.
[CUSTOMER][NEUTRAL] Get the mortgage here or not.
[CUSTOMER][POSITIVE] 21. OK, you're good and that's all good.
[CUSTOMER][POSITIVE] I love that.
[AGENT][NEUTRAL] Did the, did they hang up?
[CUSTOMER][NEUTRAL] Good Afternoon. You take South Western Pa financial team. My name is [PII]. How could I assist you?
[AGENT][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from American Public Life. I need some help with some documents that we're trying to retrieve to process, um, an insured's claim.
[AGENT][POSITIVE] She's on the line with us as well.
[CUSTOMER][NEUTRAL] You say you need documents?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, I'm on here.
[CUSTOMER][NEUTRAL] What documents are you needing?
[AGENT][NEUTRAL] So, we're needing the um itemized bill or the UBO4 form.
[AGENT][NEUTRAL] Showing the procedure codes, the diagnosis codes, and all the charges?
[CUSTOMER][NEUTRAL] OK, yes, I will need to get you over to billing. They'll be able to assist with those documents.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Yes ma'am, you're welcome just give me one moment I'll get someone from the office.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Staying on the line after speaking with our representative to be transferred to the survey.
[CUSTOMER][NEUTRAL] Did you know you can pay your bill by phone through our new automated line? Do you have a UT Southwestern MyChart account? MyChart is a helpful tool where you can check your balance, pay your bill, or even select a flexible payment plan that meets your needs. Visit [PII] and click on MyChart to learn more.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Compassionate patient care and advanced medical thinking go hand in hand at UT Southwestern Medical Center, one of the world's top academic medical centers. We treat about 80 specialties, several of which are ranked among the nation's best by US News and World Report. Visit [PII] to learn more.
[CUSTOMER][POSITIVE] We know medical expenses are often unexpected. For this reason, we created options to help make care more affordable for you. If you are having trouble paying your bill, be sure to ask our friendly team member about flexible payment options and our financial assistance program.
[CUSTOMER][NEUTRAL] We got walkie-talkies.
[CUSTOMER][NEUTRAL] But all
[CUSTOMER][POSITIVE] UT Southwestern is one of the premier academic medical centers in the nation. We integrate pioneering biomedical research with exceptional clinical care and education. Our faculty includes many distinguished members, including 6 who have been awarded Nobel Prizes since [PII]. Our UT Southwestern physicians proudly serves North Texas across 80 specialties and oversee approximately 3 million outpatient visits a year.
[CUSTOMER][POSITIVE] UT Southwestern is honored to serve patients throughout [PII]. We are proud to have been selected as the best hospital in [PII]-Fort Worth by US News and World Report, our 4th consecutive year to earn that distinction, and 10 of our specialties and 7 procedures were rated among the nation's finest.
[CUSTOMER][NEUTRAL] Did you know that UT Southwestern is offering video visits across nearly all clinical specialties? All you need is a smartphone, tablet, or computer. Please reach out to your provider or the clinic to see if your appointment qualifies to be seen as a video visit or visit [PII] and keyword search virtual care to learn more.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][POSITIVE] Mhm. Good afternoon. Thank you for calling UT Southwestern. My name is [PII]. Who do I have the pleasure of speaking with?
[AGENT][NEUTRAL] Hey, [PII]. My name is [PII]. First initial to my last name is [PII]. I'm calling from American Public Life. I'm trying to assist um a mutual patient that we have with um some documents so that we can process the claim for her. She's on the line as well.
[CUSTOMER][NEUTRAL] OK. OK, um, hi, um, do you have your guarantor number?
[CUSTOMER][NEUTRAL] I do not have my guarantor number with me. I'm sorry.
[CUSTOMER][NEUTRAL] I have the day to serve the phone number with your account.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, thank you. Give me just a moment to pull up the account and I can assist you guys with the date of service.
[CUSTOMER][NEUTRAL] What's your first and last name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And can you verify your date of birth and mailing address, please?
[CUSTOMER][NEUTRAL] Yes, [PII] [PII].
[CUSTOMER][NEUTRAL] OK, thank you and [PII], what date of service were you guys looking into?
[CUSTOMER][NEUTRAL] Well, they told me it was a group that oh you go, you go ahead, [PII]. I'm sorry.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] No, no, I don't have the data set. Oh wait, I do. Hold on, I'm sorry, I forgot we pulled the claim. Um, [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Whatever date, whatever date the infusion was on is what I need. The chemotherapy, I mean, my immunotherapy, which was my Keytruda.
[AGENT][NEUTRAL] And that was [PII].
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Probably this one.
[AGENT][NEUTRAL] And would this also be the same location, the physical therapy?
[CUSTOMER][NEUTRAL] I have some there could be.
[AGENT][NEUTRAL] OK, because we need the itemized bill, well, the UBO4 for that as well.
[CUSTOMER][NEUTRAL] Can I ask you, so you're looking to get the UBO4 for the infusion and the oh I'm sorry.
[CUSTOMER][NEUTRAL] No, you go ahead. I'm sorry.
[CUSTOMER][NEUTRAL] Um, no, I was just confirming so you guys just need the UVO4 for the infusion and for the physical therapy, correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] What I was gonna ask, while I had you both on the line, there's several things I haven't done on yet filed with my APL yet, and my other doctor suggested that I call y'all and get actually every UP every everything from February until present, and then send that over to APL as well, because some of that they know they cover. I just haven't filed for it yet because I've been so busy with sickness and doing so many things. Um.
[CUSTOMER][NEUTRAL] I began with with y'all in February of this year at UT up until current, and I would need everything if that's at all possible, and I would need it sent to APL.
[CUSTOMER][NEUTRAL] OK, yeah, so am I sending it to you directly or we're sending it to the insurance?
[CUSTOMER][NEUTRAL] I think it's gonna be uh [PII], you, you tell me.
[AGENT][NEUTRAL] Well, for the um
[AGENT][NEUTRAL] For the UBO 4 and the, what was the second thing?
[AGENT][NEUTRAL] The UBO4 for the [PII] and then for the [PII]. You can send that to us, but I have a question. Have you received the explanation of benefits from Blue Cross?
[AGENT][NEUTRAL] Blue Shield
[CUSTOMER][NEUTRAL] Me. Um, from Blue Cross, yes.
[AGENT][NEUTRAL] For, do you have one for [PII] because that's also missing.
[CUSTOMER][NEUTRAL] Um, let me pull up that data source and I can confirm with you guys. Give me just a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I wanted to ask also about the transportation.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you like that color she suggesting or do you want a different color?
[CUSTOMER][NEUTRAL] Oh, well, go get it. Hurry. If she wants to get a different color, I'm sorry. I guess she got too light. Hurry. Sorry, thank you. Hold on, baby.
[CUSTOMER][POSITIVE] I thought that was gonna be delightful.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] At home breathing the weather.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] A little bit short.
[CUSTOMER][POSITIVE] OK, you want that one? OK. Oh, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Oh, I like. That's a very trueub so.
[CUSTOMER][POSITIVE] OK, thank you for holding. So yes, we do have the um ELBs from Blue Cross Blue Shield.
[AGENT][NEUTRAL] OK, um, so we can you send the explanation of benefits and the UBO for?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] But the UBO4 is for a different data services, not 1118.
[AGENT][NEUTRAL] For [PII]:18.
[CUSTOMER][NEUTRAL] OK, so the UBO4 you guys need for.
[CUSTOMER][NEUTRAL] February all the way till present you said, right?
[AGENT][NEUTRAL] Well, hold on, hold on. Just, just for this claim, I just need the UBO4 for this [PII] is a range.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] No ma'am, no ma'am, this time it's, it's November. Remember my claim that I would have needed.
[AGENT][NEUTRAL] Wait, wait, wait, hold on. No, no, that's something different. We're gonna get that next.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, OK.
[AGENT][NEUTRAL] So for the, the physical.
[CUSTOMER][NEUTRAL] You said I'm sorry, [PII]?
[AGENT][NEUTRAL] Mhm. It says [PII], and that's what needed the um UBO for with the codes and charges.
[CUSTOMER][NEUTRAL] I don't show her for [PII].
[CUSTOMER][NEUTRAL] There's a [PII].
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Well, I mean, that includes all the dates, so I guess we can use that.
[AGENT][NEUTRAL] Because I just need the [PII], so that's before and after, so that's fine.
[CUSTOMER][NEUTRAL] And then you
[CUSTOMER][NEUTRAL] OK, and that's for physical therapy, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So she has to, she has one that's in physical therapy and one that's under labs, so I'm thinking infusions, OK.
[AGENT][NEUTRAL] Yeah, this one's just physical therapy.
[CUSTOMER][NEUTRAL] And what about my ones for the infusion?
[AGENT][NEUTRAL] Well, we're
[AGENT][NEUTRAL] The infusion is for [PII]. I'm, I'm just going through the, I'm just telling her what she needs for the dates.
[CUSTOMER][POSITIVE] Oh, I got you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Hey baby, I, I'm gonna turn it down just a little bit. Thank you.
[CUSTOMER][NEUTRAL] OK, so that one saved for you guys so I can, OK, and what's the next one that you would need?
[AGENT][NEUTRAL] So that one is [PII]. We need the um EOB from Blue Cross.
[CUSTOMER][NEUTRAL] She's gonna let me share the EOB.
[CUSTOMER][NEUTRAL] Um, OK, this one.
[CUSTOMER][NEUTRAL] Um, let me see. You like it? OK.
[CUSTOMER][NEUTRAL] Yeah, so it's no, so I'm not gonna be able to send the, you'll be able to let me send it.
[CUSTOMER][NEUTRAL] Maybe another way.
[CUSTOMER][NEGATIVE] No, no, so for that one you guys are gonna have to get it from Blue Cross because it's not allowing me to share it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And Blue Cross, I've dealt with them and they won't put it on their darn side. It keeps saying coming soon, even though it's already processed and pays for it doesn't make.
[AGENT][NEUTRAL] Well, we can um give them a call.
[CUSTOMER][NEUTRAL] OK, and then can I ask one more thing while I have both of you on the line, that idea of getting everything and my transportation taken care of, that address and all of that sent, am I allowed to do that at this time? Everything from [PII] on.
[CUSTOMER][NEUTRAL] On [PII], I believe it was.
[CUSTOMER][NEUTRAL] Sent to APL. OK, um.
[CUSTOMER][NEUTRAL] Yes, I can do that. Um, so where am I sending this directly to you, uh, Miss [PII], did you want me to send it to the insurance? It has to be an email though.
[CUSTOMER][NEUTRAL] Got you. Can I send it to both?
[CUSTOMER][NEUTRAL] Yeah, what's, um, let me see if I have your email on file. Is that still valid?
[CUSTOMER][NEUTRAL] Yes, the AN 11.
[CUSTOMER][NEUTRAL] Yes, and then if you'll take whatever information and assist to send hers to.
[AGENT][NEUTRAL] Um, so mine.
[CUSTOMER][NEUTRAL] OK and then what's your email?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] At
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Do I need to put any subjects or anything. Thank you.
[AGENT][NEUTRAL] In the subject, um, can you put uh policy number 177?
[AGENT][NEUTRAL] 5159.
[CUSTOMER][NEUTRAL] And can I ask, will that cover surgeries? Will that cover everything I've had done through UT from February on?
[CUSTOMER][NEUTRAL] Fans procedures, all of it.
[CUSTOMER][NEUTRAL] Um, yes, so include physician and hospital charges.
[CUSTOMER][POSITIVE] Awesome. I've had a lot done.
[CUSTOMER][NEUTRAL] And you want the itemized bill or you want the UBO4s?
[CUSTOMER][NEUTRAL] What do you think, [PII]?
[AGENT][NEUTRAL] The UBO4.
[CUSTOMER][POSITIVE] OK, great.
[CUSTOMER][NEUTRAL] So the the thing with the UBO4 is only gonna have your hospital services, um, so it's not like you not positions as well your position.
[AGENT][NEUTRAL] Let me see if it specifies. Hold on, because I think it did.
[AGENT][NEUTRAL] Let me look at the denial.
[CUSTOMER][NEGATIVE] It's so bad. I'm sorry.
[AGENT][NEUTRAL] Oh no, isn't that one.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] This one needs physicians, so, um, itemized bill.
[CUSTOMER][NEUTRAL] And that's starting from February up until present, correct?
[AGENT][NEUTRAL] Well, for this claim, I just, I just need December, I'm sorry, I just need November.
[CUSTOMER][NEUTRAL] Yes, ma'am. Um, one.
[AGENT][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] The ones you gave me.
[AGENT][NEUTRAL] Right, [PII], well, that's just for the physical therapy and then [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, so I have those and then the item of my statements it's all from February up until present, OK.
[CUSTOMER][NEUTRAL] OK. So give me just a moment let me download all the itemized statements and then I can send them to you guys and I can confirm if you received it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And does the [PII] 1 include my Katruda?
[AGENT][NEUTRAL] Say that one more time.
[CUSTOMER][NEUTRAL] Just the one from the [PII]. Does it include my Keytruda immunotherapy?
[AGENT][NEUTRAL] Yeah, the [PII] is the therapy. The, the December is just the physical therapy.
[CUSTOMER][POSITIVE] OK, great. Great.
[CUSTOMER][POSITIVE] Awesome. You have been so much help. Thank you so much.
[AGENT][POSITIVE] You're very welcome. That's exactly what we're here for.
[CUSTOMER][POSITIVE] No, I appreciate it.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] So when, when she sends those other ones, is there any other forms I need to attach those like the cancer form or well I mean wellness or anything else that has to be attached?
[AGENT][NEUTRAL] No, so when she sends the email to me, I'm just gonna send it over to claims to um process.
[CUSTOMER][POSITIVE] Oh, OK, awesome.
[CUSTOMER][POSITIVE] Thank you. This will, you just don't know what a load of this can take off.
[AGENT][POSITIVE] Well, if I can help, that's definitely what I'm gonna do.
[CUSTOMER][POSITIVE] Oh thank you
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] By [PII]. I like them.
[CUSTOMER][NEUTRAL] You've had another brother since the last time you saw her. They have 3 boys now. They had a new baby.
[CUSTOMER][NEUTRAL] a full house.
[CUSTOMER][NEUTRAL] I asked them when they're gonna stop and said they don't know yet.
[CUSTOMER][POSITIVE] I'll tell you, I don't know how they do it. She's a pretty big, big, big sister though. That's how we do it, isn't it, promise.
[CUSTOMER][NEUTRAL] You want it just like you did your house?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] She's like a little mama herself.
[CUSTOMER][NEUTRAL] When she comes to my house, it's a it's a break from your boys.
[CUSTOMER][POSITIVE] My daughter's been needing to get over here. She got some gift cards for [PII]. My daughter-in-law got her one too.
[CUSTOMER][NEUTRAL] She started a new job in such a friend, so she's had one day to wait.
[CUSTOMER][NEUTRAL] And she getting ready to go on her face.
[CUSTOMER][NEUTRAL] She's wanting to go back to [PII], but the borders are not really letting them come through as much as they were.
[CUSTOMER][NEUTRAL] Um, so I don't know if she's gonna get to do that one this year. She hasn't been in about 5 years now to [PII].
[CUSTOMER][POSITIVE] She loves it over there though.
[CUSTOMER][NEUTRAL] My nephew and his wife are leaving. He's gonna, he's going to the [PII] in 3 weeks. Uh-huh. Uh, my nephew, he, he goes to [PII] once in a while. He was in the military there and he was like it over there. And then his wife is actually from the [PII].
[CUSTOMER][NEUTRAL] She can go out and see her mom, I think.
[CUSTOMER][NEUTRAL] Long flight isn't it?
[CUSTOMER][NEGATIVE] Everything's gotten so expensive.
[CUSTOMER][NEUTRAL] Oh, I didn't mean to do that. Sorry, I was reading your page.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I should try that one next time.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] What's not much in the office up than that.
[CUSTOMER][NEUTRAL] Don't know yet. Mhm.
[CUSTOMER][NEUTRAL] Oh yeah, I can wait and see. I gotta go to the grocery store.
[CUSTOMER][NEUTRAL] She does a lot on the weekends, mainly sometimes, yeah.
[CUSTOMER][NEUTRAL] When she's got a break from school. Her mom homeschools, so they're pretty busy through the week.
[CUSTOMER][POSITIVE] And then they do piano lessons, so it's kind of busy with that. She loves piano.
[CUSTOMER][NEUTRAL] Promise when you go back to piano.
[CUSTOMER][NEUTRAL] So no yeah.
[CUSTOMER][NEUTRAL] And so I can.
[CUSTOMER][NEUTRAL] And I got this crazy.
[CUSTOMER][NEUTRAL] We have to arrange for that.
[CUSTOMER][POSITIVE] But I am thankful for insurance right now. I'd be in a lot of trouble without it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] I'd have to go back to work for sure.
[CUSTOMER][POSITIVE] I'm hoping maybe if I can get past everything, I'll go back in the fall of next year, go to work for the school again maybe.
[CUSTOMER][NEGATIVE] It feels weird not to work if I'm working my whole life.
[CUSTOMER][NEUTRAL] And being at home with friends.
[CUSTOMER][MIXED] It's not good stuff, but
[CUSTOMER][NEUTRAL] OK, thank you so much for holding. So that has been sent, so the PDF that says itemized statement is gonna be the itemized statement for all the data sources from February up and down and then the other one I labeled the PDF for the UBL4. Um, the PDF for the itemized statement is about 23 to 24 pages, so just so you guys know.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, besides that, is there anything else that I can assist you guys with?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um, on my transportation ones, is there a way of getting an address showing all the days that I was there? I didn't have an address for those.
[AGENT][NEUTRAL] Is it the same facility as the um
[AGENT][NEUTRAL] Billing
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] I would have
[CUSTOMER][NEUTRAL] It should be. I went to, oh, you go ahead. I'm sorry.
[AGENT][NEUTRAL] No, no, I was just asking, would it be a different, is it a different location because I'm, I'm looking in the inbox now to see to um
[AGENT][NEUTRAL] Get the email.
[CUSTOMER][NEUTRAL] It should be the same one if you were transported like to the hospital then it should be the same one that we use under billing.
[CUSTOMER][NEUTRAL] Well, this is just for my uh therapies, my immunotherapy, my chemotherapy. Those are what they pay on for you, I believe, is that correct, ma'am, on the transportation, [PII]?
[AGENT][POSITIVE] Yes, that's right.
[CUSTOMER][NEUTRAL] OK, that's what it would be for. OK then, yeah, it would be the same one that's on the um PDF on the PDF for the UBO4 that would be the same address.
[AGENT][NEUTRAL] OK, then I'll note that on the email. Um, where would it be coming from? Like what should I look for?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] It should be coming in it'll say [PII] um with UT Southwestern mhm.
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so I'll keep an eye out for it and then once I get it, I'll go ahead and send it over to claims and let them know that it's the same address, um, the the address on the documents is, is what's needed for transportation, so I'm trying to say.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hey, let me see.
[AGENT][NEUTRAL] OK, well, I think that's all we need.
[CUSTOMER][NEUTRAL] Yeah, that's the same one, yeah, it's on the one that has the UBL4.
[AGENT][NEUTRAL] You'll be off, OK, let me put that.
[AGENT][POSITIVE] OK, and that is, I think that's all we need. Thank you.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Thank you, can I ask her one thing while I, while I, while I still have you on the, while I still have you on the line, can I ask you one thing, ma'am? I'm sorry, uh, what's your name again?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][POSITIVE] [PII], um, I have a question. I called up to the billing. I, I called up to the billing department the other day and I spoke with a really kind man in there that helped me with, uh, some billing that I have to, like small bills that are starting to come in now that my out of pocket's not meant for the year yet, and he mentioned to me that if I call this number back that we deal with each one at a time and something about filling out a form to where I could get some help with those, so I just fill it out online.
[CUSTOMER][NEUTRAL] Um, do you mean like for the financial assistance?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Um, yes, you would go through my chart, so you'll go to my chart and the menu and then there's a tab that says financial assistance. You would click that one and I think it's like 3 steps you have to do on there. Mhm. Oh awesome OK thank you you ladies don't know what you have meant thank you so much for your help. You're very welcome. Thank you for.
[AGENT][NEUTRAL] You're very welcome, Ms. [PII], hold the line though, don't hang up.
[CUSTOMER][POSITIVE] OK, yes ma'am. Thank you for participating in our brief survey. Your feedback helps us improve our services to you. Let's get started. Choose any number between one and.
[AGENT][NEGATIVE] Oh, no, no, no, sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hello, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Alrighty, um, so I, I have the email here. I'm sending the documents over to claims now. Um, so it, they, um, I'm all tongue tied. Once they um receive it, they'll go ahead and continue processing, so I'm gonna say probably Tuesday because Monday is the holiday, um, and then.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Um, did you want to also call the insurance company for the explanation of benefits?
[CUSTOMER][NEUTRAL] Uh, yeah, do you think, you think we're gonna need it, don't you?
[AGENT][NEUTRAL] Yes, we definitely need the explanation of benefits.
[CUSTOMER][POSITIVE] Oh yeah, let's go ahead and do that then I'll get you their number. Hang on just a second. I think I think I have it in my purse.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh thank you. That I sit out here. Thank you, [PII]. Uh, all [PII].
[CUSTOMER][NEUTRAL] Grab my card real quick.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That would be wonderful, and I wonder if they could send all the explanation of benefits from February on that would be.
[CUSTOMER][POSITIVE] Amazing.
[CUSTOMER][POSITIVE] And with y'all, it actually another question I think I've already been paid for on it, so it won't matter, but I actually began chemo in [PII], but I think on those benefits you've already paid.
[CUSTOMER][NEUTRAL] Though Texas oncology.
[CUSTOMER][NEUTRAL] Uh, OK, let's look here. Alright, the number?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is 1866823-3790.
[CUSTOMER][NEUTRAL] And this is Blue Advantage Administration of Arkansas.
[AGENT][NEUTRAL] OK. Hold on one moment. Let me send these this over and then I'll call them. Do you mind if
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I have a lot of
[CUSTOMER][NEUTRAL] Sure. Right.
[AGENT][NEUTRAL] I, um, do you mind if I place you on just a brief hold? I'm just sending the documents over first.
[CUSTOMER][POSITIVE] Sure, thank you.
[AGENT][NEUTRAL] You're welcome hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling Walmart's healthcare advisor team at Blue Advantage National Accounts. For English, say English or press 1. For Spanish, say Spanish or press 2.
[AGENT][NEUTRAL] OK, Miss [PII], I'm back.
[CUSTOMER][NEUTRAL] If you have an identification number, please have it ready.
[CUSTOMER][NEUTRAL] If you're a provider, say provider or press 1. If you're a member, say member or press 2.
[CUSTOMER][NEUTRAL] What is your
[CUSTOMER][NEUTRAL] I didn't catch that.
[CUSTOMER][NEUTRAL] What is your NPI? Please press pound after speaking.
[AGENT][NEGATIVE] Oh, no, I don't want that.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] I don't I didn't catch that.
[CUSTOMER][NEUTRAL] What is your NPI? Please press.
[AGENT][NEUTRAL] I might have to hang up and call him back. Hold on one moment.
[AGENT][NEUTRAL] OK, I'm gonna call him back again, OK?
[CUSTOMER][POSITIVE] Hi [PII], this is the [PII]. Thank you.
[CUSTOMER][POSITIVE] Uh, thank you.
[CUSTOMER][NEUTRAL] Thank you for calling Walmart's healthcare advisor team at Blue Advantage National Accounts. For English, say English or press 1. For Spanish, say Spanish or press 2.
[CUSTOMER][NEUTRAL] If you have an identification number, please have it I don't think they're quite dry yet.
[CUSTOMER][NEUTRAL] You gotta get. That is not a valid option if you're a provider say provider or press one. If you're a member, say I don't know please speak the full.
[AGENT][NEUTRAL] If
[CUSTOMER][NEUTRAL] Don't want them to not be dry.
[AGENT][NEUTRAL] It's, it's picking up on you.
[CUSTOMER][NEUTRAL] 555 more minutes.
[CUSTOMER][NEUTRAL] Sorry, I must have heard that wrong.
[AGENT][NEUTRAL] It's picking up on you.
[CUSTOMER][NEUTRAL] Please say the full date
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] Sorry, I must have heard that wrong.
[CUSTOMER][NEUTRAL] Looks like I'll need some assistance.
[CUSTOMER][NEUTRAL] This information provided is not a guarantee of payment or coverage and is only valid if all coverage criteria is verified when the claim is received and the plan sponsor or issuer promptly funds approved claims. Oh, she said they may be monitored or recorded for quality assurance purposes. OK, sending the payroll.
[CUSTOMER][NEUTRAL] Thank you for calling your healthcare advisory team. My name is [PII]. How may I assist you today?
[AGENT][NEUTRAL] Hey, [PII], my name is [PII]. I'm calling from American Public Life. I have the insured on the line as well. I need an explanation of benefits for a date of service sent over if you can, please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, yes, but before we get started, I do have a couple of questions for you. So you're from America Public Life.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] American Public Life, we have our cancer policy.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK, yes ma'am, I'm on the line as well.
[CUSTOMER][NEUTRAL] Oh hello. Hi, um, I do have a couple questions for you. Uh, may I have the name of the state that you all are calling from? Or that one of you all are calling from [PII], OK. And, um, may I have, uh, um, [PII] from American Public Life by any chance if you don't have it it's fine, but do you have a tax ID number by any chance?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, no, I don't know our tax ID.
[CUSTOMER][NEUTRAL] OK, that's fine, that's fine. um, um, and then for the member, may I have your member ID number then?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am. I have to dig it out or give you my social. Which one do you want?
[CUSTOMER][NEUTRAL] Um, I can take your social if you're OK with it.
[CUSTOMER][NEUTRAL] Yeah, that's fine. [PII].
[CUSTOMER][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] And may I have your name and date of birth please?
[CUSTOMER][NEUTRAL] Yes, [PII], [PII].
[CUSTOMER][NEUTRAL] Alright thank you may I have the address listed on file please?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[CUSTOMER][POSITIVE] Alright, thank you.
[CUSTOMER][NEUTRAL] I have a telephone number here listed as [PII]. Is that a good telephone number we can use to contact you if needed?
[CUSTOMER][NEGATIVE] No, ma'am, never heard of that number, don't know why that's even in there.
[CUSTOMER][NEUTRAL] OK, uh, it's probably just what came up through the automated system. What is a good telephone number we can use to contact you if needed?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and do we have permission to call that number back if needed?
[CUSTOMER][NEUTRAL] 2, yes, you can call me back on that number, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, um, is there EOB for a particular data service that you're looking for?
[AGENT][NEUTRAL] Yes, I need, uh, let me go back to the claim. Hold on one second.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] You know by any chance what the total bill amount is?
[AGENT][NEUTRAL] Um, it came in with others. Let me see.
[CUSTOMER][NEUTRAL] If you
[CUSTOMER][NEUTRAL] Yeah, 50,000.
[CUSTOMER][NEUTRAL] OK, let me see if I can pull that up for immunotherapy.
[CUSTOMER][NEUTRAL] 7:18.
[CUSTOMER][NEUTRAL] It's doing dirt girly. I know that you can't right now because I'm on the phone with the doctor. I wish I could.
[CUSTOMER][POSITIVE] I love it, OK.
[CUSTOMER][NEUTRAL] You're gonna show me how it works. I haven't got to look at it good. Oh, did it go dead on you? Oh, I'm sorry. We won't be much on you to go to [PII] for the grant.
[CUSTOMER][NEUTRAL] I think the donut shops probably closed right now.
[CUSTOMER][NEUTRAL] I, I figured they were.
[CUSTOMER][NEUTRAL] Is it uh several days of service or like uh [PII]?
[AGENT][NEUTRAL] If that's the only thing you have, I'll take it, but I just need the [PII], so as long as the [PII] is on there, that's fine.
[CUSTOMER][NEUTRAL] OK, because we have a lot of clients.
[AGENT][NEUTRAL] Because I have the I have the [PII] and the [PII].
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well, I guess who is the, are you looking for the provider University of Texas Southwestern or OK, I just wanna make sure because that's the claim that we have, uh, for a total bill amount of $51,797.44.
[AGENT][NEUTRAL] Let me, let me see if
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, let me see if I see a total.
[CUSTOMER][NEUTRAL] I'm sorry, how much was that again?
[CUSTOMER][NEUTRAL] Uh, $51,797.44. That's the one? OK.
[AGENT][NEUTRAL] Mhm. Yes.
[CUSTOMER][NEUTRAL] Uh, let me see if I can pull that up that I'm not ready yet.
[CUSTOMER][POSITIVE] That's OK. Let's swim down on the floor. No, no, let's swim on the floor for [PII]. OK, thank you. That's sweet.
[CUSTOMER][NEUTRAL] I want to. I don't want him up there. I'm there. Oh, we're playing store, I see.
[CUSTOMER][NEUTRAL] Here I'll buy some fingernail polish instead.
[CUSTOMER][POSITIVE] Thank you. How much do I owe you? $12. Here you go. Thank you, ma'am. Have a great day.
[CUSTOMER][NEUTRAL] Can I get a bottle of water too?
[CUSTOMER][NEGATIVE] How much will that be? $3 man, you're expensive.
[CUSTOMER][NEUTRAL] Let's see, OK, so I do have an explanation of benefits. Are you wanting it to be faxed or emailed or how would you like that to be sent out?
[AGENT][NEUTRAL] Um, you can email it to me.
[CUSTOMER][NEUTRAL] OK, now I do wanna let you know it's not gonna be emailed immediately. It actually goes through our correspondence department, so it's gonna take around unfortunately 5 to 7 business days, 3 to 5 business days. I'm sorry for that to, uh, get to you now, um.
[CUSTOMER][NEUTRAL] Let me see if we're able. I don't know if you have one.
[AGENT][NEUTRAL] Is faxing quicker?
[CUSTOMER][NEUTRAL] So we
[CUSTOMER][NEUTRAL] Well, I was gonna ask I I have to check to see if I can fax it, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then also the member does have access to this online. Uh, if that faxing don't work, that will be the quickest way to get it online and send it that way uh but let me check, uh, really quickly if you don't mind, can I put you all on a short 2 to 4 minute hold while I just check to see if I can fax this? Alright, thank you.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] No, I, yeah, can I hang up.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, no, tomorrow night.
[CUSTOMER][POSITIVE] Alright, thank you for holding so I can go ahead and fax it if you have a good fax number I can send it to.
[AGENT][NEUTRAL] OK, um, it's [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And it'll be attention um APL claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, give me one second, attention, um, you said APL claims department.
[AGENT][NEUTRAL] Uh-huh. Can you put a policy number on it?
[CUSTOMER][NEUTRAL] Sure, policy number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 177.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 5159.
[CUSTOMER][NEUTRAL] 1775159 OK um and let's see.
[CUSTOMER][NEUTRAL] It all there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, um, I'll go ahead and send this I just sent it off so you all should receive it within the next couple of minutes or so.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I forgot to put that down. Well, no, no, I, I got that. OK, um, is there anything else that I can assist you out with today?
[AGENT][POSITIVE] No, that's it. Thank you very much. Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Well, I
[CUSTOMER][NEUTRAL] Um, I, I do have one question for both of you while I'm on the line. OK, so on my other claims that I have through since I began cancer treatment, there's several things that I have not filed on through y'all that through American Public Life. Is there any way while we have this young lady on the line that she can send you all of that as well, just like the other ones did a while ago.
[CUSTOMER][NEUTRAL] The, uh, whatever we're needing, um, for everything that would be from the date of service all the way from [PII], all the way to, uh, you know.
[CUSTOMER][POSITIVE] Diagnosis to now and that way I don't miss anything that I haven't forgotten to file.
[CUSTOMER][NEUTRAL] And look at that down.
[CUSTOMER][NEUTRAL] Um, let me see because that would, that would be.
[CUSTOMER][NEUTRAL] Like I mean, what is that baby? sorry.
[CUSTOMER][NEUTRAL] I'm just trying to see um.
[CUSTOMER][NEUTRAL] OK, so we might have to, what date was your original diagnosis?
[CUSTOMER][NEUTRAL] My original that I believe it was [PII].
[CUSTOMER][NEUTRAL] Oh, OK, so we might need to do something like a.
[CUSTOMER][NEUTRAL] Claims history report cause you're talking about like.
[CUSTOMER][POSITIVE] Over 10+ documents that I would have to send in that case, um, yes, and it was a lot. I just know I've missed things that I haven't filed on yet. I've missed everything, but there's some that I need to get over to American Public Life, and this has been such an easier way of doing it than me fishing through all of this.
[CUSTOMER][NEUTRAL] Especially in the middle of, you know, trying to. Yes.
[CUSTOMER][NEUTRAL] Let me see if I sent because if you hear what you're talking about, oh, you go ahead I'm sorry.
[CUSTOMER][NEUTRAL] Well, no, I was just gonna say essentially, uh, in order for me to do those I would need to know like what specific dates of service, otherwise we might be just sending them a lot of filler documents and so I would need to know like what date of services that you have those services rendered things of that nature, um, do I know which services.
[AGENT][NEUTRAL] Now, for that, it might be, for that it might be easier to wait until you're you're ready to process the claim or to be honest, this usually comes over with the claim, so this 1 may have just slipped through the cracks when they sent it over because they had the they had the um copy of it, they just couldn't send it. So that may be just a one-off because usually they send it with everything else.
[CUSTOMER][NEUTRAL] And I had surgeries.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then if we don't receive it, we'll have a data service that we can then ask.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Blue Cross 4.
[CUSTOMER][NEUTRAL] But it won't be too late later to go back and do this if I need to call on some other claims.
[AGENT][NEUTRAL] Oh no, you don't have a um like a deadline to file a claim as long as your policy is active on, you know, whatever date of service you can file at any time.
[CUSTOMER][NEUTRAL] You know Valentines.
[CUSTOMER][NEUTRAL] Take a picture of that page for me in a minute with my phone. OK, sorry, I'm talking.
[CUSTOMER][NEUTRAL] Go ahead, I'm sorry.
[AGENT][NEUTRAL] No, no, I was just saying so there's no like deadline to file the claim, so you can file it at any time as long as your policy is active. So if you, it'll be easier to let the provider go ahead and file the claims like they did and then if something is missing, we then have a specific date of service we can ask for because if not, they're just gonna send a whole bunch of documents.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][POSITIVE] Oh, OK, awesome.
[CUSTOMER][POSITIVE] OK, well that sounds great then we'll just leave that alone for now then.
[AGENT][POSITIVE] OK, well that's all we need. Well, thank you very much.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Oh thank you um would you like a reference number for our conversation?
[AGENT][NEUTRAL] Um, no, I'm OK.
[CUSTOMER][POSITIVE] OK I'm OK alright OK alright well if there is anything else, um, I hope you all have a great day and a great weekend.
[AGENT][NEUTRAL] OK, Ms. [PII], hold the line.
[AGENT][POSITIVE] Thank you you also.
[CUSTOMER][POSITIVE] Thank you you too. All right, thank you bye bye.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Hello, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] All right, so we got everything together. I I already sent the documents over uh to claims from Irene. I got that email and then I'm looking in the faxes for um the fax. It hasn't come through yet, but it's going straight to the claims department. That fax number I gave her was directly to claims. So that once they get it, they'll have your policy number there so they can go ahead and process it in case.
[CUSTOMER][POSITIVE] Oh awesome.
[AGENT][NEUTRAL] I don't see it or something it's going straight to them.
[CUSTOMER][NEUTRAL] Right. Well, maybe within the next couple of weeks. I'm hoping then, do you think it'll take more than 2 weeks?
[AGENT][NEUTRAL] Oh, no, because they already have the other documents and then as soon as they receive the fax, they'll go ahead and start processing that. So I would, I mean just to be on the safe side, I would say 2 weeks, but it could be before then though.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEGATIVE] OK, great. You do not know how much help you have been this is been so worrisome, so.
[AGENT][POSITIVE] Well, I'm very glad I could assist you. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, ma'am. God bless you and you have a good day.
[AGENT][POSITIVE] Thank you you also and thanks for calling APL.
[CUSTOMER][NEUTRAL] Uh-huh, bye-bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] I I promise now you