AccountId: 011433970860
ContactId: 4548faf2-4b5a-41e3-90c4-44c4f15f9b0f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2241389 ms
Total Talk Time (AGENT): 518697 ms
Total Talk Time (CUSTOMER): 988879 ms
Interruptions: 8
Overall Sentiment: AGENT=0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/4548faf2-4b5a-41e3-90c4-44c4f15f9b0f_20250610T17:03_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Um, yes, I filed a claim and I was missing my diagnos my my diagnostic code, and I'm trying to send that information in with the diagnostic codes, but.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] I, I had to reregister for my account and it doesn't show my old stuff so I need help.
[AGENT][NEUTRAL] OK. uh, what is your name and policy number, please?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and my policy number is 02478752ML.
[CUSTOMER][NEUTRAL] 7.
[AGENT][NEUTRAL] OK, thank you. And Miss [PII], excuse me, do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Well, it's just some claims process on the 2nd, so you probably won't.
[AGENT][NEUTRAL] See it, um, but let me look at something. Give me one moment.
[CUSTOMER][NEUTRAL] Well, it might be different because my husband has processed claims as well.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK one moment to see if it lets me look in here.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] Oh
[AGENT][NEGATIVE] Why are you not working with me?
[CUSTOMER][NEUTRAL] Um
[AGENT][NEGATIVE] OK, this screen don't work for me, OK.
[AGENT][NEUTRAL] Well, anytime, uh, if you're submitting additional information for a claim, you won't be able to submit it on a claim that has already been processed or been received, you will have to do it as a new claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I sent in about.
[CUSTOMER][NEUTRAL] 18 EOBs.
[CUSTOMER][NEUTRAL] About 2 weeks ago. And then I got back.
[CUSTOMER][NEUTRAL] I got like 18 pieces in the mail.
[CUSTOMER][NEUTRAL] So I called and I was told I needed to submit the diagnosis code. So I just got the diagnosis code with all of my visits on it and what do I do? I have to resubmit 18 forms separately again?
[CUSTOMER][NEUTRAL] I thought it
[AGENT][NEUTRAL] No, you, if the, the information that you have with the diagnosis codes for each data service, is it on a couple of pages or one page or is it for each one?
[CUSTOMER][NEUTRAL] OK, what do I do?
[CUSTOMER][NEUTRAL] It's on 5 pages. It's just like a printed out invoice and it has each visit and it's the same diagnosis code for all of them.
[AGENT][NEUTRAL] OK, well, that's fine. You can just upload that document.
[AGENT][NEUTRAL] You don't have to do it 18 times. They would just go back into history and verify from that um document you sent the diagnosis code for each one so they can reprocess.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I am on your APL website. Can you tell me how I would do this?
[AGENT][NEUTRAL] Uh, you would create your OSC account.
[CUSTOMER][NEUTRAL] Which I already have. It's my 2nd 1 because I had to start over last week and I don't see.
[CUSTOMER][NEUTRAL] I don't when I log in it says [PII] resources. How do I get out of resources? Can you hold one second?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK. Hello, how are you?
[CUSTOMER][NEUTRAL] Uh, usually the assistant, but whoever walks the patient out has to be well versed on the patient.
[CUSTOMER][NEUTRAL] Order that it's the assistant.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Fine, I'll tell them to let the doctor be putting in the notes and codes while the assistant walks them up front.
[CUSTOMER][NEUTRAL] OK all right OK bye.
[AGENT][NEUTRAL] Resource center.
[CUSTOMER][NEUTRAL] Hello? Hi, sorry. OK, so, so I'm, I'm in the resource center. How do I get, when I go to home, I'm still in resource center. How do I get to just.
[AGENT][NEUTRAL] Yes, ma'am. No, you're fine.
[CUSTOMER][NEUTRAL] My account.
[CUSTOMER][NEUTRAL] return to OSC. What's OSC?
[AGENT][NEUTRAL] Online service center.
[CUSTOMER][NEUTRAL] Is that where I wanna be?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so should I go in the dashboard my policy resource center or help to find my to do this?
[AGENT][NEUTRAL] To upload it should have um need to file a claim. Give me one moment to pull up a user account.
[CUSTOMER][NEUTRAL] Start your claim, but it doesn't have oh here.
[CUSTOMER][NEUTRAL] Dashboard, it says CO 577493, maybe that's my claim.
[CUSTOMER][NEGATIVE] But I can't click into it.
[AGENT][NEUTRAL] Uh, you would go to.
[AGENT][NEUTRAL] Well, it's just need to file a claim or a wellness claim or traditional claim, start your claim. That's where you would upload a claim document.
[CUSTOMER][NEUTRAL] OK, so how do I know that it knows that this new account is linked to my old account?
[CUSTOMER][NEUTRAL] Because I've already submitted it, but it's not showing in this.
[CUSTOMER][NEUTRAL] I submitted it under my old account and then your system went down and they told me I had to re-register, so how do I know that it will link the two? Do you know what I'm saying?
[AGENT][NEUTRAL] I get what you're saying, but no, it will link the two because all the information that we're showing in our system should show on the online service center.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, it didn't transfer to mine, but now I'm in start your claim, so do I select the claim type?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Next step.
[CUSTOMER][NEGATIVE] It won't let me select the claim type.
[AGENT][NEUTRAL] It should show covered individuals.
[CUSTOMER][NEUTRAL] Nope, it doesn't.
[CUSTOMER][NEUTRAL] I could put you on the phone. Are you here from your coach.
[CUSTOMER][NEUTRAL] I have it and come with your partner when it's filled out and when will that be?
[CUSTOMER][POSITIVE] Um, I'm not here tomorrow, but I'll be here Thursday or all day today, OK, and have your partner fill that out too. Thank you so much. I'll see you soon. Try to let me know when you're coming if you can, yeah, email or email me all day today and most of the day Thursday. OK, fine, just no later than Thursday, OK.
[CUSTOMER][NEUTRAL] I'm sorry, it won't let me. It says traditional claim.
[AGENT][NEUTRAL] No, you're fine.
[CUSTOMER][NEUTRAL] And it won't let me click into anything here. OK, next step policy information to find the claim form you need.
[CUSTOMER][NEUTRAL] Let's see, select claimant name, OK.
[CUSTOMER][NEUTRAL] Select coverage type.
[CUSTOMER][NEUTRAL] Um, this one ends in a 42. OK. Next step.
[CUSTOMER][NEUTRAL] Select coverage for 247, OK?
[CUSTOMER][NEUTRAL] Next step, drop files here OK or click here to browse.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So I sent in the ledger, 5-page ledger that the physical therapy place sent me and it has my diagnosis code on there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So may I assume that when you get it you'll find the old claims I did which were under my old account?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, can you see how many claims I made, what the dates were, so that I can send in any additional dates I've had since then since I can't access them I wanna know what you received.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] See.
[CUSTOMER][NEUTRAL] It says it was successfully submitted and that's what it said last time but I wasn't able to print the dates.
[AGENT][NEUTRAL] Uh, it looks like several dates, um, and
[AGENT][NEUTRAL] [PII], and May.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You want each date? Sure. [PII], 327.
[CUSTOMER][NEUTRAL] Can you give me the dates? Yes, please.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] 3:31.
[AGENT][NEUTRAL] 42.
[AGENT][NEUTRAL] 4749 411.
[AGENT][NEUTRAL] For 14, for 16, for 18.
[AGENT][NEUTRAL] 421, 425, 428.
[AGENT][NEUTRAL] 51.
[AGENT][NEUTRAL] C
[AGENT][NEUTRAL] Did you get him?
[CUSTOMER][NEUTRAL] Yeah, I, I didn't know you were done. 51 was the most recent one.
[AGENT][NEUTRAL] 519 was the most recent one.
[CUSTOMER][NEUTRAL] OK, I then I must have lost you between 51 and 519. I heard you say 51. What was the next one?
[AGENT][NEUTRAL] 55.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 58
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 512.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 5:15.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And 5:19.
[CUSTOMER][NEUTRAL] Perfect. OK, so all those should be on the ledger. So anything I've had since then, do I need to send in the new EOB or is this ledger that shows what Blue Cross Blue Shield paid? Is that enough? Or do I have to send in the EOBs for anything additional since [PII] now that you have this ledger?
[AGENT][NEUTRAL] Uh, anything after [PII], any claim you submit, we always need the billing with diagnosis code and primary EOB. So on the ledger, does it show other dates, but after [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, let me see. Yeah, let me see what it shows like the [PII]. It shows therapeutic exercises with the diagnosis code, the patient's name, the Blue Cross Blue Shield, but it doesn't show the $20.
[CUSTOMER][NEGATIVE] It doesn't show.
[CUSTOMER][NEUTRAL] Yeah, it shows my $20 payment, but it doesn't show that insurance left $20 and I noticed on this patient ledger it doesn't have the name of the place, Palm Beach Institute for Sports Medicine, but it's on my EOB. Is that gonna be sufficient?
[AGENT][NEUTRAL] Um, if it's on the ledger for those other dates after [PII], then we will need those ELBs for those dates.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and as long as you have the EOBs if the patient ledger doesn't show the name of the facility, will you be able to match it up to the EOBs or do I have to have them send me another patient ledger with the name of the place on it?
[AGENT][NEUTRAL] Uh, they should be able to match it with the EOBs because they'll go by the procedure code and the amount of the charge.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, um, do you by any chance have access to receiving this or does it, are you not able to access what I sent to look and make sure this should be sufficient?
[AGENT][NEUTRAL] Um, let me see, give me one moment.
[AGENT][NEUTRAL] Sometimes it takes a while for us to see it in our system, but give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, on these.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] I'm looking at the information submitted.
[AGENT][NEUTRAL] And it doesn't have the diagnosis codes. Those codes, you see, the 97,110, 97,140, those are procedure codes showing that.
[AGENT][NEUTRAL] Physical therapy was performed or manual therapy was performed.
[CUSTOMER][NEUTRAL] OK. So you need the diagnosis code, not the treatment code?
[AGENT][NEUTRAL] The proceed, right. Uh, the diagnosis code is also called an ICD 10 code.
[AGENT][NEUTRAL] And who is your major medical insurance with?
[CUSTOMER][NEUTRAL] Wait, can you, can you say that?
[CUSTOMER][NEUTRAL] Blue Cross Blue Shield.
[AGENT][NEUTRAL] It's not Florida blue?
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] Because
[CUSTOMER][NEUTRAL] Maybe.
[AGENT][NEUTRAL] Most are on the [PII].
[CUSTOMER][NEUTRAL] My Blue Cross Blue Shield is flew south.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[AGENT][NEUTRAL] Because most times uh with Florida blue.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] They have diagnosis codes on the EOB on their health statements. Uh give me one moment and seeing what we received previously.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I sent you the EOB from my website.
[AGENT][NEUTRAL] And it doesn't have the diagnosis code, so, um.
[AGENT][NEUTRAL] Yeah, I'm look, like I said, I'm looking at the information you submitted, but it doesn't have the diagnosis codes that are needed to process. It just has the procedure codes.
[CUSTOMER][NEUTRAL] OK, so then the codes that start with 97 or procedure codes. So they sent me the wrong ones. OK. So now I have to, oh, can I call you with the diagnosis code or you need it in writing?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, we need it in writing.
[CUSTOMER][NEUTRAL] OK, and do you need the name of the facility on there? I mean, probably the referral from the doctor would have the diagnosis code, is that correct?
[AGENT][NEUTRAL] Um, but it's
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Uh I'm not sure.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Is there any way I could try to call the facility and talk to the person with you on the line so they get this right?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, hold on, let me see if, let me give me a minute and let's see, um.
[CUSTOMER][NEGATIVE] Cause I, I feel like I'm getting nowhere here.
[CUSTOMER][NEUTRAL] Alright, let me see if I can reach them. Hold on, OK? Thank you. And also I'm frustrated because I'm in my account but I don't see my old claims anywhere. Are they gonna merge my two accounts?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, it's not, it's still under the same policy number just because it's not probably showing on the new online service center doesn't mean that it's not showing in our system where they actually process the claim. It's just probably not showing the ELBs yet on the online service center since it's just been updated.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] This weekend or last.
[CUSTOMER][NEUTRAL] OK, so it will eventually, will it eventually? OK, all right, that's my concern. OK, hold on, let me try to call this person directly. Hold on, let me pull up my email and get it.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes, I have her extension hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Hi. Hi, so I have [PII] on the line from the physical therapy facility and I have APL American Public Life, my secondary insurance on the line. [PII], you had just sent me um something when I had requested the diagnosis code, but it was the treatment codes and they need the diagnosis code.
[CUSTOMER][NEUTRAL] OK, can I give that to you over the phone?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh, you can ask APL, will you take it over the phone?
[AGENT][NEUTRAL] Uh, no, ma'am. We can't take it over the phone. We need it in writing.
[CUSTOMER][NEUTRAL] OK, OK, so do you need the notes then? I mean, I've, we've never had an issue with sending over the billing ledger and it being a problem, but I can give you her individual notes for physical therapy that'll have the diagnosis codes on there.
[CUSTOMER][NEUTRAL] [PII], do you have my original referral from Doctor [PII]? Because that information is not gonna, I mean, the doctor can write whatever they want on there, but the physical therapist note is what matters as far as the diagnosis code goes. Well, they're telling me a diagnosis code is different than the than the therapy code that's that's built. So because you have the CPT code which is the procedure code for every single visit.
[CUSTOMER][NEUTRAL] And then you have the diagnosis code and that remains the same your entire therapy so you have pain in left knee pain in right knee, so you have two diagnosis codes that are shared for your entire case. OK, so, so, so APL are what's the diagnosis code supposed to begin with because I see here 971-4097110, the diagnosis code is.
[AGENT][NEUTRAL] Those are CPT codes.
[CUSTOMER][NEUTRAL] Yeah, those are the diagnosis code is a letter followed by numbers and some maybe some decimals, um, so I have um it's M25.562 and then uh and then Z 96.652 are your two diagnosis codes that we have. But it's not on the ledger. OK, so like I said, I can give you all of your notes which have the diagnosis code on every single visit note.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I have to send all my notes to [PII]. I mean that's like my patient record stuff. I, I don't know why they're requesting this like I said, I've never had a problem or anyone request this, so.
[AGENT][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Or I can just I can write an email if you want.
[AGENT][NEUTRAL] A
[AGENT][NEUTRAL] No, ma'am. We need an actual billing.
[CUSTOMER][NEUTRAL] And just say the diagnosis code for her case.
[AGENT][NEUTRAL] With diagnosis codes.
[AGENT][NEUTRAL] But let me, I I can transfer you to a claims representative and they can verify if they can take notes, but hold on one moment for me, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah please that would be great. You know, I, I had my other knee done a year ago and whatever I submitted from Palm Beach Institute was fine then so I don't know [PII] what we gave a year ago, but it was, it's that I had my right knee done a year ago and my left knee done 11 months later and eventually I got all my payments back from American public life but I'm not getting very far now.
[CUSTOMER][NEGATIVE] I personally have used APL following a surgery and I submitted the exact same thing I've I've done this before and never had an issue so it must be a policy change that they did or something that is new. You are on hold.
[AGENT][NEUTRAL] That's because we had diagnosis codes.
[AGENT][NEUTRAL] I swear people get on the last.
[CUSTOMER][NEUTRAL] Transferring.
[AGENT][NEUTRAL] Jesus, [PII].
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Are you the only one that answers phones, woman?
[CUSTOMER][NEUTRAL] Mm, pretty much.
[AGENT][NEGATIVE] Hm, lucky you, you get, you get another call. This is a, a doozy.
[CUSTOMER][NEUTRAL] Uh oh right.
[AGENT][NEUTRAL] I have the insured on the phone. Oh Lord, I don't know how where that accent come from. I have an insured on the phone, she called the provider's office and she is calling about all these 18 claims that she submitted for these dates of service and they were needing uh the diagnosis codes.
[CUSTOMER][NEUTRAL] Oh [PII].
[CUSTOMER][NEUTRAL] OK, hold on, let me look at.
[AGENT][NEUTRAL] Well she submit information in today through the OSC and what it is is a patient's ledger, but it just has procedure codes, so I told her that we need the diagnosis codes, where she has Katie from the provider's office on the phone and they're saying, well, back in the day, there was never a problem anyway.
[AGENT][NEUTRAL] I can go a whole bank these people. Anyway, the thing is on this um.
[AGENT][NEUTRAL] The provider said they can send her notes.
[AGENT][NEUTRAL] Her treatment notes that has the diagnosis code for each date. Can we accept that?
[CUSTOMER][NEUTRAL] What's your policy number?
[AGENT][NEUTRAL] 247-875-2.
[AGENT][NEGATIVE] They just trashing us while they thought I was placing on hold. Yes I am.
[CUSTOMER][NEUTRAL] Oh, OK. They just they talking about that. Yeah, if the doctor's notes, cause the doctor's notes probably gonna tell why she came in for treatment, yeah.
[AGENT][NEUTRAL] OK. So the treatment notes or doctor's notes are fine.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Alright, thank you, ma'am. Let me let them know. So yeah, we'll have this.
[CUSTOMER][NEUTRAL] As long as it tells why she came in to see.
[AGENT][NEUTRAL] All right. Well, thank you. Yay, I don't have the attention.
[CUSTOMER][NEUTRAL] Yay, do you're not gonna allow them with that couple with a couple for 30 minutes yesterday.
[AGENT][NEGATIVE] Shut up.
[AGENT][POSITIVE] I am so sorry.
[CUSTOMER][NEUTRAL] From the time that you sent them to me until I got off.
[CUSTOMER][NEUTRAL] It was time for me to clock out when I got off the phone with them.
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] But they, but they weren't, they weren't bad though.
[AGENT][POSITIVE] No, no, she was super sweet. That lady, yesterday she was super sweet, but this one, she's detail is all get out and she wanted every single date that they she sent that we needed. So anyway.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, alright then, ma'am.
[AGENT][NEUTRAL] At least she's not yelling because she has to send it, but anyway, let me let her know so I can get this woman off the phone. I appreciate you. Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright thank you.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][POSITIVE] No problem bye bye.
[CUSTOMER][NEUTRAL] And I don't asking.
[AGENT][NEUTRAL] OK, ladies.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you so much for holding. I just spoke with an examiner and she said if you have the medical notes where it shows diagnosis codes, that is acceptable.
[CUSTOMER][NEGATIVE] OK, what about if I give you a um because that's kind of a violation of her privacy. Yeah, I'm not happy with that. So why don't I send you a, I have a charges report that'll show you a diagnosis code, a CPT code, and time for every single visit and it doesn't give you details of, you know, everything else.
[AGENT][NEUTRAL] Well, that's fine as long as it shows the date of service and the diagnosis codes, that's fine.
[CUSTOMER][NEUTRAL] Would that be sufficient? OK.
[CUSTOMER][POSITIVE] Yep OK perfect I'm gonna send this over to her and that she can forward it to you. Um, does it have the name of, can you put it on your letterhead or something so there's not gonna be an issue with. It's coming straight from our EMR software so it has all of our information on there. OK, fantastic if you send that to me I'll upload it to them um [PII] we were [PII] and I were just talking when I did this a year ago she sent this exact same thing I just sent and it was acceptable a year ago. Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm not sure. Um, what was the date of service from last year? Because I, I'm looking at claims that were processed because we had the diagnosis code and they were able to be processed and paid.
[CUSTOMER][NEUTRAL] I have a I I sent um the patient the ledger on [PII], um, and the date of service were from [PII].
[AGENT][NEUTRAL] And this is for Ms. [PII]?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yep mhm.
[CUSTOMER][NEUTRAL] I'm looking at the ledger in the email now.
[AGENT][NEUTRAL] And when was it sent?
[CUSTOMER][NEUTRAL] But [PII], I just sent you the charges report so you have everything let me go and make sure I received it.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Well, our process has always been the same. Any time a claim is submitted, we always need billing showing diagnosis and procedure codes like with the other insurance company. And since we are secondary, we always need the primary EOB as well. Most um providers would send the
[CUSTOMER][NEUTRAL] I'm just going based off of what I sent you previously, so that's all.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well, you know what, the good news is I received this, and it has a diagnosis code for each appointment and it has the name of the facility. It's like a long one, but I'm sending it anyway. And then will you keep this on file for the ones I haven't submitted for yet? Will this be stay on file? So, oh well this only.
[AGENT][POSITIVE] OK, good deal.
[AGENT][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] This, yeah, let's see what dates this goes through trying to figure it out. [PII], so it goes upward so some of these I haven't claimed yet because I haven't gotten the EOB.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] But you'll keep this on file so when I send in the EOB I don't have to send it with each one.
[AGENT][NEUTRAL] It will always be on file, yes.
[CUSTOMER][NEGATIVE] That'll be on file so they'll check against it without asking me for it again.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Right, OK, very good. I will download this [PII] thank you um as always you are the most efficient person. I know you even answer the phone it's incredible thank you I'll I'll get in touch with you if I need you further, OK? Awesome thank you. And I'm gonna go ahead and go into my account and download this again to you APL and you wanna hold and make sure it's OK?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright [PII] let me know if you get anything else, OK? Thank you of course bye bye. EPL like now.
[CUSTOMER][NEUTRAL] Uh, desktop.
[CUSTOMER][POSITIVE] Great, OK, now let me go back to my.
[CUSTOMER][NEUTRAL] American Public Life.
[CUSTOMER][NEUTRAL] And here's the other, are you here American Public Life?
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] Hello? OK, perfect. OK, so now I'm in my trying to get into my dashboard.
[CUSTOMER][NEUTRAL] Uh, skip start your claim next step.
[CUSTOMER][NEUTRAL] Select claim type.
[CUSTOMER][NEUTRAL] Fix up
[CUSTOMER][NEUTRAL] Appointment name.
[CUSTOMER][NEUTRAL] Next up.
[CUSTOMER][POSITIVE] So the coverage next step upload files perfect drop files here.
[CUSTOMER][NEUTRAL] APL this is the one I just did.
[CUSTOMER][NEUTRAL] Oh gosh.
[CUSTOMER][NEUTRAL] APL, why isn't it coming up that I just saved it.
[CUSTOMER][NEUTRAL] 135 and this one shows.
[CUSTOMER][NEUTRAL] OK, here's the 2nd ledger.
[CUSTOMER][NEUTRAL] OK, submit.
[CUSTOMER][NEUTRAL] OK, so I submitted it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So see, give me one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK one moment.
[AGENT][NEUTRAL] OK, give me one moment. I hadn't come through yet so I can see it.
[CUSTOMER][POSITIVE] OK. I have no problem at all.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, this will work. It shows the dates and it has the diagnosis code, so.
[AGENT][POSITIVE] We can use this to process, yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you'll be able to use this until I'm like another month until I'm all done with the physical therapy when I send in more EOBs, you'll have that on file correct? or does it have to be submitted for each visit? OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Now,
[CUSTOMER][NEUTRAL] OK, very good so then um once you do all this, are you sending me a check? I forget how what how the process works.
[AGENT][NEUTRAL] Let me see if we have direct deposit information. Give me one moment.
[AGENT][NEUTRAL] Uh payable else send out, uh, direct deposit because it looks like you have, uh, direct deposit information in the system.
[CUSTOMER][POSITIVE] Perfect. OK. And how long does it normally take?
[AGENT][NEUTRAL] Usually 7 to 10 business days from the time claim has been received to process.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And will it go into my new online account the information will they, will they correspond to my new account that I set up?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. Great. Thank you so much for your patience.
[AGENT][POSITIVE] Oh, you're welcome. Thanks for calling APL. Have a great day, Miss [PII].
[CUSTOMER][NEUTRAL] OK. Sure.