AccountId: 011433970860
ContactId: 5c2489bf-be9f-4989-8459-e6ec79ccb736
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2161479 ms
Total Talk Time (AGENT): 668498 ms
Total Talk Time (CUSTOMER): 547799 ms
Interruptions: 10
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/5c2489bf-be9f-4989-8459-e6ec79ccb736_20250521T12:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name's [PII]. I'm with the uh Memorial Healthcare in [PII]. We have a patient that has several denied claims. I'm just trying to figure out, um.
[CUSTOMER][NEUTRAL] Her account, can you help me?
[AGENT][NEUTRAL] OK, so you're needing information on the night claim, [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. and [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number, please?
[CUSTOMER][NEUTRAL] 02230112.
[AGENT][NEUTRAL] Thank you. One moment while I get the member's information pulled up, please.
[CUSTOMER][POSITIVE] Thanks.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, [PII], any information that I provide will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, what other, I'm sorry, what other information did you need? Her date of birth is [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so do you have claim numbers um that you're needing to look at, [PII], or just do you have the dates of service and build outs?
[CUSTOMER][NEUTRAL] So I have um dates of service she has a range.
[CUSTOMER][NEUTRAL] Going back several, um, going from [PII].
[AGENT][NEUTRAL] OK, so I'll need the.
[AGENT][NEUTRAL] Well, so I'll just need the dates of the data of service and the bill amount for that data service.
[CUSTOMER][NEUTRAL] OK, so the one I'm looking at right now is 123 of 25.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and the bill amount for that, please?
[CUSTOMER][NEUTRAL] So do you need the
[AGENT][NEUTRAL] For that for data service, $70. OK, thank you. One moment.
[CUSTOMER][NEUTRAL] $70.
[CUSTOMER][NEUTRAL] That's what's sitting at the balance primary paid.
[AGENT][NEUTRAL] OK, so we don't even have a claim. Yes ma'am, we don't even have a claim for [PII].
[CUSTOMER][NEUTRAL] Dropping the 70 to the secondary.
[CUSTOMER][NEUTRAL] OK, well that answers that one.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] That's good. So let's go to um 8, this is, this is the date of service [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, it's the same patient.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do you, that was what do you need the total was.
[AGENT][NEUTRAL] And the build amount. I need the total build amount. Mhm.
[CUSTOMER][NEUTRAL] 200
[CUSTOMER][NEUTRAL] $266.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Why isn't that on here?
[CUSTOMER][NEUTRAL] Oh it is.
[AGENT][NEUTRAL] OK, so this claim was received and the claim number is 351.
[AGENT][NEUTRAL] 7357
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And this claim was denied.
[AGENT][NEUTRAL] The reason for the denial is that office visits are not covered under this policy. The supplemental policy doesn't cover office visits.
[CUSTOMER][NEUTRAL] Now my question to you is, um, it looks like the majority of this patient's accounts are office visit related.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] So am I to assume, go ahead.
[AGENT][NEUTRAL] No, go ahead. Go ahead with your question. Mhm.
[CUSTOMER][NEUTRAL] So she's got another date of service [PII], same thing.
[AGENT][NEUTRAL] Same amount.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] $266.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] Bear with me just one second.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] And yes ma'am, we did receive a claim for that data service and that claim number is 352-4852.
[AGENT][NEUTRAL] And that claim was also denied as office visits are not covered.
[AGENT][NEUTRAL] And the other codes that were on the claim were
[CUSTOMER][NEUTRAL] So should I assume.
[AGENT][NEUTRAL] They have denial remarks, but it states on there, I'm sorry, I'm having trouble with one of my screens not wanting to provide.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] The other codes that were on that claim just state this policy does not provide a benefits for services in which no charges were incurred.
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] That's the remark code for the other.
[AGENT][NEUTRAL] Codes that were billed with that office is that.
[CUSTOMER][NEUTRAL] Yeah, so
[CUSTOMER][NEUTRAL] So am I to assume that all of these, so she's got several outstanding accounts from last year and they appear to be all office visits.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do you wanna go through each one or?
[CUSTOMER][NEUTRAL] Am I safe to assume it's not covered because we already know per her policy.
[AGENT][NEUTRAL] Well, I, we can't, I mean, if it's an office visit, it's not covered. If we can go through every one of them that you have, but office visits under this supplemental policy are not covered. And then, um,
[AGENT][NEUTRAL] Now we can review office treatment under her outpatient benefit, but an office visit isn't covered.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Can you look at date of service [PII]?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Total charges were 183.
[AGENT][NEUTRAL] OK. That claim was also received 3, the claim number is 352-484-3.
[AGENT][NEGATIVE] And it was also denied as office visits are not covered.
[CUSTOMER][POSITIVE] Perfect
[CUSTOMER][NEUTRAL] All right, so let's go to the next one.
[CUSTOMER][NEUTRAL] Oops, now there goes my think we we jinxed each other.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, 10 7 [PII] 24.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $340 was are the charges.
[AGENT][NEUTRAL] OK, that's also, that's on claim number 3526571.
[AGENT][NEGATIVE] And that was also denied as office visits not covered.
[CUSTOMER][POSITIVE] Perfect
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] The next one is date of service [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Total charges were $220.
[AGENT][NEUTRAL] Claim number is 3526568 and it was also denied as office visits are not covered.
[CUSTOMER][NEUTRAL] Um, the next one is date of service [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 291.
[CUSTOMER][NEUTRAL] Uh, it looks like it's $320 total.
[AGENT][NEUTRAL] Alright, so give me just a moment. There's several on here just a second.
[CUSTOMER][NEUTRAL] Yeah, she's got a lot of.
[AGENT][NEUTRAL] And then we don't, uh, let me check this last one, but I don't think that we even have a claim for that data service for that build out.
[CUSTOMER][NEUTRAL] For 1011?
[AGENT][POSITIVE] Correct for the 320.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] So no claim on file OK.
[AGENT][NEUTRAL] But let me double check. Yeah, let me double check one more.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No, we do not have a claim on file.
[CUSTOMER][POSITIVE] Perfect, OK.
[CUSTOMER][NEUTRAL] Um, the next one.
[CUSTOMER][NEUTRAL] It looks like the data service is 116 of 24.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, total bill amount was $315.
[AGENT][NEUTRAL] OK, the claim number is 3539013 and
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] I'm sorry, 353-901-3?
[AGENT][NEUTRAL] 9013 and that one was also denied as office visits are not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, [PII] of [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sorry, when I give you the date then I.
[CUSTOMER][NEUTRAL] Pushing me back out.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Where did it go?
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] What what date of service did I give you [PII]?
[AGENT][NEUTRAL] [PII]. Mhm.
[CUSTOMER][NEUTRAL] Oh, I'll have to add them all up.
[CUSTOMER][NEUTRAL] 267.
[CUSTOMER][NEUTRAL] 323.
[CUSTOMER][NEUTRAL] $12 602 dollars.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Check one more, but I don't think we have that one. You said the total bill amount is $602?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Edit it right?
[CUSTOMER][NEUTRAL] 67
[AGENT][NEUTRAL] OK, so, yeah, hold on one second.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so for that data service for Memorial Medical Associates is the provider, is that correct?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] So that claim was received, that was received and the claim number is 3541386.
[AGENT][NEUTRAL] There was a benefit on that claim paid in the amount of $16.75.
[AGENT][NEUTRAL] That was on.
[AGENT][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] Yeah I'm not showing it.
[AGENT][NEUTRAL] that claim was issued on a single check 2018527.
[CUSTOMER][NEUTRAL] 201.
[AGENT][NEUTRAL] 85
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] 27
[CUSTOMER][NEUTRAL] 527201. I'm sorry I got that wrong 201.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 2018527.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The PO box that was sent to us, yes, [PII].
[CUSTOMER][NEUTRAL] Just for $16.
[AGENT][NEUTRAL] 4827. Mhm.
[CUSTOMER][NEUTRAL] Yep, that's our PO box.
[CUSTOMER][NEUTRAL] Yeah, I'll check for that payment.
[CUSTOMER][NEUTRAL] Are you able to see if it cleared your bank?
[AGENT][NEUTRAL] It's not showing that it has.
[CUSTOMER][NEUTRAL] OK, do you know when it was cut?
[AGENT][NEUTRAL] 1216 and 24.
[CUSTOMER][POSITIVE] Cut 1216 of 24 perfect.
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Are you able to go look at another one?
[AGENT][NEUTRAL] Give me just one moment.
[CUSTOMER][NEUTRAL] 857.
[AGENT][NEUTRAL] OK, and the next data service.
[CUSTOMER][NEUTRAL] 18 of 25.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Total was 22475.
[CUSTOMER][NEUTRAL] But I guess that's
[AGENT][NEUTRAL] No claim on file for [PII].
[CUSTOMER][NEUTRAL] What about [PII]?
[AGENT][NEUTRAL] Total bill amount.
[CUSTOMER][NEUTRAL] Um, 1850914 $271.35.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] How many, what was the change?
[CUSTOMER][NEUTRAL] 75 cents 25 I'm sorry $271.75.
[AGENT][NEUTRAL] OK, alright, so let me change that.
[AGENT][NEUTRAL] OK, so that claim number it was received is 356-8810.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] If someone was denied also and office visits are not covered.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] All right,
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, what about 123 of 25?
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] 1868.
[CUSTOMER][NEUTRAL] 570.
[CUSTOMER][NEUTRAL] Oh I gotta add them all up.
[CUSTOMER][NEUTRAL] 4
[CUSTOMER][NEUTRAL] $685404.50.
[AGENT][NEUTRAL] 404.50. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so this claim was also received. The claim number is going to be 356-8809.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] It was also denied.
[AGENT][NEUTRAL] Its office visits.
[AGENT][NEUTRAL] Not covered?
[AGENT][NEUTRAL] And then the other codes were denied as policy provides no benefits for the treatment of conditions other than a sickness or injury as defined by the policy.
[CUSTOMER][NEUTRAL] OK, and so and that's the $70 balance to the patient?
[AGENT][NEUTRAL] We do not determine any patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Are you able to um look at another patient?
[AGENT][NEUTRAL] OK, so, so you have more than one patient?
[CUSTOMER][NEUTRAL] I don't know what your quote.
[AGENT][NEUTRAL] For
[CUSTOMER][NEUTRAL] I do. I'm working on denied claims from [PII], but I don't know if you have a quo of what you can look at. This patient has two claims.
[AGENT][NEUTRAL] No, I can help you. Mhm.
[CUSTOMER][NEUTRAL] Are you able to
[CUSTOMER][POSITIVE] OK perfect um his his last name is [PII].
[AGENT][NEUTRAL] And then, but I'm not ready to move. Yes, ma'am, but I'm not ready to move on yet. So, on this, also, um [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] If you need a copy of any of those explanation of benefits, then you can, you should be able to print them if you go to our portal located at [PII].
[AGENT][NEUTRAL] And then on the claims that we did not have on file, if you are going to be filing them, you will need to also include a copy of her primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because we do have to have that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what is the next member's policy number?
[CUSTOMER][NEUTRAL] 02230095
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And same with this one, any information that's provided will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Date of birth
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you
[AGENT][NEUTRAL] OK, and what is the first day of service and total bill amount?
[CUSTOMER][NEUTRAL] 10:30 2024.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $1,237.
[AGENT][NEUTRAL] OK, so this claim was also received. The claim number is 3539024.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $111.40.
[AGENT][NEUTRAL] That was on check number [PII].
[AGENT][NEGATIVE] And there was one line item denied because office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] Um, all right, let me put that in there.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, the next date of service for.
[AGENT][NEUTRAL] And that check does show, oh, I'm so sorry. I was just gonna say that check does show cleared. [PII].
[CUSTOMER][NEUTRAL] Yeah, I'm gonna have to try to find it.
[AGENT][NEUTRAL] And it was sent to that same PO box.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Yeah, yep.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Same patient date of service is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 2446.
[CUSTOMER][NEUTRAL] Um, total charges.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm adding them up 20. It looks like it was $510.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so this one was received. Claim number is 353-3407.
[AGENT][NEGATIVE] And it was also denied, office visits are not covered.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] This is a different patient.
[AGENT][NEUTRAL] OK, so we're, you're ready to move on, OK.
[CUSTOMER][NEUTRAL] You tell me when you're ready.
[CUSTOMER][NEUTRAL] I yeah, moving on from that guy.
[AGENT][NEUTRAL] Do you know approximately how many you have today, [PII]?
[CUSTOMER][NEUTRAL] Um, this will be the last 3 because I have to move on to, um, I think.
[AGENT][NEUTRAL] Well, I mean, we
[AGENT][NEUTRAL] I can do as many as you have for APO. I'm just curious as to how many patients you have, not just dates of service.
[CUSTOMER][NEUTRAL] I have a I have a I have well.
[CUSTOMER][NEUTRAL] Well, let me see.
[CUSTOMER][NEUTRAL] I think that's uh I think after we do.
[CUSTOMER][NEGATIVE] This guy I'm done with American.
[AGENT][NEGATIVE] Yes, we don't have a limit because, yes, we don't have a limit. If you have 100, I'll check 100. If you have 2, I'll check 2 because you're just gonna, there's no point in hanging up and calling back. That doesn't.
[CUSTOMER][NEUTRAL] So, um, I'm.
[CUSTOMER][POSITIVE] Wow.
[AGENT][NEUTRAL] We don't
[CUSTOMER][NEUTRAL] And that's what they do to me, yeah, for sure, OK.
[AGENT][NEUTRAL] Well, that's not how we work because you're calling back and it's to the same company, so no, ma'am, we handle, we handle our calls as they come in.
[CUSTOMER][NEUTRAL] Crazy, yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] You tell me when you're ready for the next one.
[AGENT][POSITIVE] I am ready.
[CUSTOMER][NEUTRAL] Um, oh, you need the claim number 382. I'm sorry, yeah, 38.
[AGENT][NEUTRAL] Policy number.
[AGENT][NEUTRAL] No, I need the policy number.
[CUSTOMER][NEUTRAL] Yep, 38294.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 681-1.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now that's not an APL policy number.
[AGENT][NEUTRAL] 382-946-811
[CUSTOMER][NEUTRAL] Let's see if she's got it.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Is that a social security number?
[CUSTOMER][NEUTRAL] I'm I'm checking your other accounts.
[AGENT][NEUTRAL] OK. Yeah, cause that's not a.
[CUSTOMER][NEUTRAL] That's just what they have for a policy. Let me see if they scan, yeah, I'm gonna see if they scanned the card.
[AGENT][NEGATIVE] Yeah, because that's not, that's not a valid number for our company anyway.
[CUSTOMER][NEUTRAL] Bear with me.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] 02230092 is her policy number.
[AGENT][NEUTRAL] OK, say that, say that one more time.
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] 223-0092
[AGENT][NEUTRAL] 02230092. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, and again, any information provided will be a verification of benefits and not a guarantee of payment and the patient's name and date of birth on this one.
[CUSTOMER][NEUTRAL] Patient's name is [PII]
[CUSTOMER][NEUTRAL] Birth date is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Appears to be an office.
[CUSTOMER][NEUTRAL] Oh, total charge is $266.
[AGENT][NEGATIVE] OK, hang on just a second. I'm not ready for that.
[CUSTOMER][POSITIVE] You got it.
[AGENT][NEUTRAL] Just a minute.
[CUSTOMER][POSITIVE] I can't tell you how much I appreciate you, [PII].
[AGENT][POSITIVE] Oh well, you're very welcome. Sure is my pleasure.
[AGENT][NEUTRAL] OK, and what's the date of service for her, please?
[CUSTOMER][NEUTRAL] Um, PO1 I guess.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh. And the total bill amount again?
[CUSTOMER][NEUTRAL] $266 even.
[AGENT][NEUTRAL] OK, so this claim was also received. The claim number is 351-7510.
[AGENT][NEUTRAL] And this claim was denied as office visits are not covered.
[CUSTOMER][NEUTRAL] Um, the next date of service for [PII] is [PII].
[AGENT][NEUTRAL] Oh, hang on one second.
[AGENT][NEUTRAL] OK. [PII] of [PII]. Mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And the total.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, $103.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, now on this claim, who is the provider of service?
[CUSTOMER][NEUTRAL] This was an urgent care visit um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It looks like she saw a nurse.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] What's the name of the urgent care?
[CUSTOMER][NEUTRAL] It says Urgent Care Health Park.
[AGENT][NEUTRAL] What's the tax ID number?
[CUSTOMER][NEUTRAL] Uh, tax ID number is [PII].
[AGENT][NEUTRAL] But um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. I just want to make sure this is the correct information. OK. So this claim was received.
[CUSTOMER][POSITIVE] Yeah for sure.
[AGENT][NEUTRAL] The claim number is 354.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 9600.
[AGENT][NEUTRAL] There was a benefit paid in the amount of $60.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That was on check number 2022176.
[AGENT][NEUTRAL] Oh, let me get my fingers on the right keys here.
[CUSTOMER][NEUTRAL] You know what did we get that?
[AGENT][NEUTRAL] And that shows that was received also.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][POSITIVE] Yeah, yep, there's a check here OK we can move on from this one.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, and then the, the last one.
[AGENT][NEUTRAL] And that
[AGENT][NEUTRAL] OK, is it a different patient or a different data service for [PII]?
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] No this is this is this this is the same patient.
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] Different data yep different this is the last one.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, 99 of 24.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $340 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so this one was also received. Claim number is 352-487-6.
[AGENT][NEGATIVE] And that one was also denied his office visits are not covered.
[CUSTOMER][POSITIVE] Perfect, thank you so much, [PII] I appreciate you.
[AGENT][NEUTRAL] Well, you're welcome. Absolutely, sure. And is that, are you sure that's all the ones you have for [PII] to check?
[CUSTOMER][NEUTRAL] Yeah it looks like that's.
[CUSTOMER][NEUTRAL] Yeah, I'm looking through her spreadsheet trying to help the.
[CUSTOMER][POSITIVE] Filler, yep, that's it for American. OK, you have a good rest of your day.
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] OK. And again, well, I hope you do too, and if that's all I can help you with, sure, it was my pleasure in speaking to you this morning and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] You're welcome bye.
[AGENT][NEUTRAL] Uh-huh.