AccountId: 011433970860
ContactId: 296d9f01-d7ef-4e7a-b413-f24e1e438552
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 535419 ms
Total Talk Time (AGENT): 139956 ms
Total Talk Time (CUSTOMER): 175049 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/296d9f01-d7ef-4e7a-b413-f24e1e438552_20250108T16:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello [PII]. My name is [PII], that is [PII] And is your name [PII] or [PII]?
[AGENT][NEUTRAL] I have an H at the end.
[CUSTOMER][NEUTRAL] OK, um, I am calling to confirm one if a patient is active and if they are active, did you receive the claim that we sent to you all?
[AGENT][NEUTRAL] OK, I'm happy to check on the uh policy status in a claim. Do you have their policy number, [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am I do. I was trying to look it up online actually and not have to call you all, but I am not able to gain access because it's asking me for a control number.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I have that policy number is.
[CUSTOMER][NEUTRAL] 02479866
[CUSTOMER][NEUTRAL] And this will be for the date of service of [PII].
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Alright, let me take a look here.
[AGENT][NEUTRAL] And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] of [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So, patient's policy is still active. Uh, the effective date on this is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you all just didn't receive the claim.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Let me see here I'm taking a look. What was the bill amount for [PII]?
[CUSTOMER][NEUTRAL] $38,866.74.
[AGENT][NEUTRAL] Do you have an amount after the primary by chance or?
[CUSTOMER][NEUTRAL] $1,535.76.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so yeah, it looks like [PII] we didn't receive any claims for that billed amount that I see.
[CUSTOMER][NEUTRAL] OK, so let me ask you this next, how can I, because I was trying to set up the portal and so whenever I put new user, it asked me one question we move on to the next step on step 2, it asks me for a tax ID and patient account number.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] I don't have a patient account number.
[CUSTOMER][NEUTRAL] Is that something that you can provide or?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me take a look here.
[AGENT][NEUTRAL] OK, so it does say the provider must have already filed a claim with APL in order to set up the online service center. Do you know if you guys have ever filed a claim with us?
[CUSTOMER][NEUTRAL] I'm not sure I can provide you my tax ID number and maybe we can go from there um I would love to prevent a call if a call don't have to be made if I can just.
[CUSTOMER][NEUTRAL] Access the information online.
[CUSTOMER][POSITIVE] However if that, I mean if that's not possible I totally understand. I don't wanna make it a hassle.
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] Let me see here.
[AGENT][NEUTRAL] I'm trying to see if there's a way that I can just search by your tax ID and see if you guys.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, what's the um ID the taxpayer ID that you have.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, so yeah, it does come up as UCC Midland Memorial Hospital, but it looks like we don't have any sort of W-9 on file and so all of that has to be looks like collected to set up the OSC online so.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, that's not a problem. um, can you tell me if this policy is fully or self funded?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Um, it looks like the policy itself is issued through the insured's employer.
[AGENT][NEUTRAL] Is that what you're looking for or?
[CUSTOMER][NEUTRAL] Um, it usually just say if it's fully or self funded.
[CUSTOMER][NEUTRAL] It's fine though, um, and can I fax this claim or?
[AGENT][NEUTRAL] Yeah, absolutely, and we have a payer ID. I can give you all that information. Uh, the fax number is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, that's [PII].
[AGENT][NEUTRAL] Yes ma'am mhm.
[CUSTOMER][NEUTRAL] OK one moment.
[CUSTOMER][NEUTRAL] Let me see if I can locate the payer ID just to confirm that it's the same.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I don't even know what it'll be in with.
[CUSTOMER][NEUTRAL] I'll just send the claim and if anything if it's wrong then it of course will be sent back so.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do I need to put attention anything?
[AGENT][NEUTRAL] Uh, you can just put attention claims.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes ma'am, I will do that and thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And can I have a call reference number please?
[AGENT][NEUTRAL] Yeah, absolutely. So that's going to be my name with my last initial and then today's date. My name again is [PII], that's [PII] and the last initial to my name is [PII].
[CUSTOMER][POSITIVE] [PII]. Alrighty, thank you so much, [PII]. You have a good rest of the day.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You too. Take care. Bye bye.
[CUSTOMER][NEUTRAL] Mm