AccountId: 011433970860
ContactId: 3263863a-0bf4-4eee-bfe5-6ede61a09481
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 292850 ms
Total Talk Time (AGENT): 121899 ms
Total Talk Time (CUSTOMER): 126764 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/3263863a-0bf4-4eee-bfe5-6ede61a09481_20250410T16:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm from a provider's office. Um, it was about a week ago I spoke to um someone there to make sure that you guys got some claims from us and you had not received them. It was [PII] I spoke to and so I resent them with a corrected member ID and I sent electronically to your payer ID so I'm just calling to whether you actually got them.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, Ms. [PII], I can check on the claims to see if we've received them for you. Can I please get your callback number, ma'am, and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Certainly, um, my direct line is [PII].
[CUSTOMER][NEUTRAL] And um I'm calling from Augusta Lung Associates.
[AGENT][POSITIVE] OK, thank you so much. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] The name is in the er [PII].
[CUSTOMER][NEUTRAL] Um, date of birth is [PII], and the ID is 02311714.
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We'll check it.
[AGENT][NEUTRAL] OK, I do show the policy now. Let me look and see if we've received any claims. Do you remember what day you sent them on?
[CUSTOMER][NEUTRAL] Yes ma'am, we sent them on [PII], about a week ago.
[CUSTOMER][NEUTRAL] Electronically.
[AGENT][NEUTRAL] And you
[AGENT][NEUTRAL] Through the online service center um through the um payer ID number 60801.
[CUSTOMER][NEUTRAL] Yes ma'am, um, but when I put it in the system, the system converted it to Z like zebra 6 excuse me, let me start over Z like zebra 961.
[CUSTOMER][NEUTRAL] 49.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does that sound familiar?
[AGENT][NEUTRAL] Yes, ma'am. And I do see that we have received the claim.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] I got 12357 claims maybe.
[AGENT][NEUTRAL] On
[AGENT][NEUTRAL] Right, we received it on the [PII], which was the day that you mentioned that you sent it.
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And uh,
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] There's already a status on it, so let me see what that says.
[CUSTOMER][NEUTRAL] OK, that's odd.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me check this policy and it was received on the policy number 2586493.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, that.
[CUSTOMER][NEUTRAL] May have been how we.
[CUSTOMER][NEUTRAL] Originally sent it but I was told when I spoke with [PII] that it's oh the policy and the member ID are different, right?
[AGENT][NEUTRAL] Right, so the first member ID number that you gave me is a lapsed policy.
[AGENT][NEUTRAL] So they put it on the active policy, but this does have a remark that they're waiting eligibility for this patient for that date of service. Once we receive the eligibility, the claim will be reprocessed automatically.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Got it, so just to make sure there's no issues, um, when should I call back just to make sure?
[AGENT][NEUTRAL] You can um try back in uh.
[AGENT][NEUTRAL] I would give it a week.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And then try back and see you know what the status of the claim is at that time.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Will do [PII] thank you at least we got got it moved a little bit forward um can I get a call?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I'll take a call reference number then and I'll let you go.
[AGENT][NEUTRAL] OK, um, you can use my name, [PII], and today's date.
[CUSTOMER][POSITIVE] Got it. All right, [PII], thank you again. You have a good day.
[AGENT][POSITIVE] You too, Ms [PII] you have a blessed one and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you. Goodbye.
[AGENT][NEUTRAL] Bye-bye.