AccountId: 011433970860
ContactId: 4884f8e1-a7a7-471c-ae97-23a0b6b640a8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 872940 ms
Total Talk Time (AGENT): 219618 ms
Total Talk Time (CUSTOMER): 136773 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/4884f8e1-a7a7-471c-ae97-23a0b6b640a8_20250221T18:28_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATF. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling to get the status of a claim, please.
[AGENT][NEUTRAL] OK, [PII], I can help you with the claim. What is your callback number please just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] [PII] [PII], 7.
[AGENT][NEUTRAL] OK. And what is her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[AGENT][NEUTRAL] OK, and then what is the date of service?
[CUSTOMER][NEUTRAL] The date of service is [PII].
[CUSTOMER][NEUTRAL] The total bill was $4,647.
[AGENT][NEUTRAL] OK, and then what is the amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] $1040.54.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Thank you and then one last question, can you please give me the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Baptist Health Medical Group orthopedics.
[AGENT][NEUTRAL] OK, I'm gonna um put you on a brief hold, [PII], while I look up this claim for you and I will be right back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 4000
[AGENT][NEUTRAL] 356-068.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh, that's not it.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you, [PII] for holding for me.
[AGENT][NEUTRAL] So I looked for the data service of uh [PII] and I do not find a claim on file for the amount that you have given me.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah, I faxed it on with the primary EOB to.
[CUSTOMER][NEUTRAL] [PII] on [PII].
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Uh, let me see if I've got anything coming in around that time and check that it might have a different amount.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] The fax confirmation was received at [PII] on [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Right, and I'm looking and I do see that we did pay Baptist Health, um, a claim, but it's nowhere near the amount that you've given me.
[AGENT][NEUTRAL] Uh, let me keep looking.
[CUSTOMER][NEUTRAL] You paid the hospital then, the facility.
[CUSTOMER][NEUTRAL] New page just Baptist House Japtist Hospital.
[AGENT][NEUTRAL] Yeah, Baptist
[AGENT][NEUTRAL] Baptist
[AGENT][NEUTRAL] Baptist Health Medical Group.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Oh, Baptist Health Medical Group.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] But that is the only thing that I show. Let me see if this one might be it. No, that's not you.
[AGENT][NEUTRAL] Let me see what this complete name is on this one.
[CUSTOMER][NEUTRAL] There is another claim that you guys did pay $96.84.
[AGENT][NEUTRAL] No, that's not this one either um let me look at this one real quick.
[AGENT][NEUTRAL] We paid back as health medical group physicians, so that's not the same as.
[CUSTOMER][NEUTRAL] No, that's a different tax ID.
[AGENT][NEUTRAL] Um, orthopedic. Right. That's not the same as the orthopedic.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] I'm still not showing that we received it for the Baptist Health Orthopedic.
[AGENT][NEUTRAL] Now we have a mailing address along with a payer ID number. The payer ID number is if you wanna send it electronically.
[CUSTOMER][NEUTRAL] It doesn't go through electronically for some reason. I don't know why.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEGATIVE] But the fax number that I gave you was not correct?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] yeah [PII] yeah.
[AGENT][NEUTRAL] Yes, ma'am, and I'm
[CUSTOMER][POSITIVE] That's exactly where I sent it.
[AGENT][NEUTRAL] Yeah, and I'm not saying that we have received anything.
[AGENT][NEUTRAL] Around the time that you said that you sent it, so I'm not showing it.
[AGENT][NEUTRAL] Can you try to refax it?
[CUSTOMER][NEUTRAL] Yeah I can do it right now hold on.
[AGENT][NEUTRAL] OK, now I can't see it come through um it goes through a process with the claims department.
[CUSTOMER][NEUTRAL] Well, can someone investigate the facts then?
[AGENT][NEUTRAL] Yes, I can send in a hub request to have somebody investigate the facts.
[AGENT][NEUTRAL] I'm gonna put you on a brief hold.
[CUSTOMER][NEGATIVE] Yeah, because I have confirmation, yeah, I'm, I'm gonna resend it though but just uh I, I'm just don't understand why it wasn't received.
[AGENT][NEUTRAL] Right, I understand. And what was the date that you said you sent it in on again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK and then what is your guys' tax ID number?
[AGENT][POSITIVE] So we can make sure we get the right.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And that's Baptist Health Orthopedics.
[CUSTOMER][NEUTRAL] Baptist Health Medical Group orthopedics.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I send in a request to have somebody research that fax for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And um.
[AGENT][POSITIVE] I'll be right back just as soon as I get it completed, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right, thank you, Ms. [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, Ms. [PII]. I've got that request in now for the research to be done on the facts for that claim.
[CUSTOMER][NEUTRAL] OK, I just refaxed it again.
[AGENT][POSITIVE] OK, good, good deal. Alright, and you should be getting a call back within 24 hours, um.
[AGENT][NEUTRAL] For the finding of the first claim.
[CUSTOMER][POSITIVE] OK, great.
[CUSTOMER][POSITIVE] Great. May I get your reference number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome, [PII]. You have a good weekend and thanks for calling APL.
[CUSTOMER][NEUTRAL] You too, bye.
[AGENT][NEUTRAL] Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Bye