AccountId: 011433970860
ContactId: 5eea005d-e060-4a69-8d34-7d7d86641971
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 812260 ms
Total Talk Time (AGENT): 260913 ms
Total Talk Time (CUSTOMER): 557476 ms
Interruptions: 11
Overall Sentiment: AGENT=1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/5eea005d-e060-4a69-8d34-7d7d86641971_20250220T20:24_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good Morning. Thank you for calling. I'm so sorry. Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] How you doing, [PII]? That's all right. Um, my name is [PII]. I don't know if it's Saturday or or Tuesday.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Morning or afternoon or night, right?
[CUSTOMER][NEUTRAL] Oh my goodness, my name is [PII], and I'm calling from provider's office MUSC physicians hoping that you could help me with claim status, please, ma'am.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] It would be my pleasure this afternoon. What is that callback number?
[CUSTOMER][POSITIVE] Thank you, thank you.
[CUSTOMER][NEUTRAL] It's [PII] and that's direct.
[AGENT][NEUTRAL] Thank you. And aren't you glad this afternoon instead of morning unless it's tomorrow morning, Friday morning would be OK.
[CUSTOMER][NEUTRAL] What? I got one hour, right, I have one more hour. If it was Friday, that would be real good.
[AGENT][NEUTRAL] Oh, yeah, it's a common.
[CUSTOMER][NEUTRAL] Uh-huh, so.
[AGENT][NEUTRAL] Slowly but surely, right?
[CUSTOMER][NEGATIVE] Right, that part because I'm so sleepy.
[AGENT][NEUTRAL] Well, what is the patient's policy number, [PII]?
[CUSTOMER][NEUTRAL] It is we have uh 02265945.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Alright, thank you, and it would be my pleasure to help you with that claim status for [PII]. What is the data service?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It is 9-182024.
[CUSTOMER][NEUTRAL] The bill amount is $277.
[AGENT][NEUTRAL] And again, that's for [PII]?
[CUSTOMER][NEUTRAL] No, ma'am, [PII].
[AGENT][NEUTRAL] That's what
[CUSTOMER][POSITIVE] Uh, that's good.
[AGENT][NEUTRAL] That's what I typed in was [PII].
[AGENT][NEUTRAL] I think there's a disconnect between my brain and my mouth. I don't know.
[CUSTOMER][POSITIVE] That's all right.
[CUSTOMER][POSITIVE] It could be, um, did you have lunch already? Because you know how we get after we eat. We could take a nice little nap. That's right.
[AGENT][NEUTRAL] You know I did.
[CUSTOMER][NEUTRAL] You're ready to put your feet up.
[AGENT][NEUTRAL] Oh, girl.
[CUSTOMER][POSITIVE] Oh my goodness.
[AGENT][NEUTRAL] Well, I don't have a claim for 9-1824 either.
[CUSTOMER][NEUTRAL] OK, for $277 you don't, OK, because I did, uh.
[AGENT][NEUTRAL] I don't have that. Now her policy was active.
[CUSTOMER][NEUTRAL] It was OK because I did resubmit it. I don't let me see why I thought I had to. I went on the portal and it wasn't on the portal. Um, let me verify this address if you would mind [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's correct. Do you have an active portal portal account?
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] You can upload that claim directly online.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, I'm looking at it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So need to file need to file a claim it says start here.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Really?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's filing a claim like.
[CUSTOMER][NEUTRAL] Like putting it straight on the portal, huh? Date of birth. I'm a little nerve. I'm gonna be a little nervous, but you know what? I'm gonna try it and if not, do you have a fax number or anything or?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] Sure do.
[CUSTOMER][NEUTRAL] OK, I'll take that.
[AGENT][NEUTRAL] Claims fax number is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] I sure am. I'm gonna try this right here, claiming first name and where where it says upload documents that means like the primary ELB.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] That would be the your um you bill on a.
[AGENT][NEUTRAL] CM as 1500.
[CUSTOMER][NEUTRAL] Secondary
[CUSTOMER][NEUTRAL] Uh-huh, yes ma'am.
[AGENT][NEUTRAL] So that would be you would upload the CMS 1500 and the EOB.
[CUSTOMER][NEUTRAL] Wow, because the first step is file a claim, put the claimant's first name, which would be [PII], and then you put the last name and it would be, I don't wanna hold you up.
[AGENT][NEUTRAL] No, you're fine if you wanted to walk through it and then.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] And then I'll make sure it gets, I mean I I'll be able to see it on the policy after you upload it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, thank you. Date of birth is [PII] and the last four of her social, get that.
[CUSTOMER][NEUTRAL] It's [PII] copy.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, next insured flow files, uh, so that would be that probably that prime.
[CUSTOMER][NEUTRAL] What do you think? Please verify the information for those correct at least.
[AGENT][NEUTRAL] What is it saying?
[CUSTOMER][NEUTRAL] Uh, please verify the information below is correct. At least one file must be uploaded before submitting. All uploaded documents must be for one date of service per claimant. Additional date of service and or claimants should be uploaded as separate claims.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So acceptable file types are like the PD PDF which I'm thinking would that be the uh primary EOB from uh UHC.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] OK, so first I need to save that so that I could be able to attach.
[CUSTOMER][POSITIVE] I appreciate you staying with me oh.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, go here print.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Invoice number 2025 here.
[CUSTOMER][POSITIVE] I'm moving as fast as I can to T E R I B E S A P A N E.
[CUSTOMER][POSITIVE] L E O B OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So now I can go to select files.
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEGATIVE] Oh would have never told me this right here.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, and so that's and that's it? I don't have to put in like lines and and all of that? OK, so just hit submit right now.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Go ahead and hit submit and I'll tell you when we get it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Isn't that wonderful?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] I feel like, I feel like a little kid, somebody tickle in my stomach.
[AGENT][NEUTRAL] Yeah, and I don't know why, you know, it's just, and you should be, yeah, and you should be getting a uh confirmation that it was uploaded.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Are you serious?
[CUSTOMER][NEUTRAL] I do have one you want me to give you the confirmation number?
[AGENT][NEUTRAL] No, I don't need it. I can.
[CUSTOMER][NEUTRAL] Well, I'm OK, I'm gonna use it for my note.
[AGENT][NEUTRAL] Once it pops in, I can see it.
[CUSTOMER][NEUTRAL] My God, my God, OK, I'm, I'm about to do this right here.
[AGENT][NEUTRAL] Sometimes it takes a minute to pop in on our side.
[CUSTOMER][POSITIVE] That's alright. I'm enjoying your conversation. Uh, I am enjoying. What's your name? Can you tell me your name?
[AGENT][NEUTRAL] Sure. My name is [PII].
[CUSTOMER][NEUTRAL] Alicia.
[CUSTOMER][NEUTRAL] [PII] OK per [PII] I uploaded that.
[CUSTOMER][NEUTRAL] The portal.
[AGENT][NEUTRAL] Just waiting for it to come up. Boy, it is slow on my side. It's usually I can see it pretty quickly.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Uh huh, it was, it was, it was so, um, we've been spinning. I've been getting notifications saying, uh, the reload, reload, reload on all of the payers. Uh, I mostly do, uh, miscellaneous commercials, so I got mom pops, uh, all, all different kinds, but the major.
[CUSTOMER][NEUTRAL] Um, payers, Blue Cross, UAC, you know, stuff that avail, and uh they're telling me to redirect, so we're thinking that something is definitely going on somewhere.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You never know these days what's going on.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Mhm. Right, especially after to change health.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What laptop?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That was yeah mhm.
[AGENT][POSITIVE] Just what, whatever. We're just gonna get, we're gonna take each day as a blessing and whatever happens.
[CUSTOMER][POSITIVE] Thank you ma'am, thank you ma'am.
[AGENT][POSITIVE] We're gonna roll with it.
[CUSTOMER][POSITIVE] Roll with it, roll where the fans at.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Now, let, let me, let me ask you, [PII], did you get that confirmation that it was uploaded successfully? Good deal.
[CUSTOMER][NEUTRAL] Oh my [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Uh huh yeah, claim uploaded successfully.
[CUSTOMER][NEUTRAL] And I have a confirmation number that I added to my my um timeline uh.
[AGENT][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] As long as it
[CUSTOMER][MIXED] As long as I got that, even if it moves slow on your end, it, it you will eventually see it soon.
[AGENT][POSITIVE] Yes, we should, we should see it soon.
[CUSTOMER][NEUTRAL] Oh the OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And how long would it take for processing 30 days?
[AGENT][NEUTRAL] Normally between 7 to 10 days, give or take a day here or there.
[CUSTOMER][NEUTRAL] Get the knife. Oh my god, OK.
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] Now we can't, you know, we process claims in order that we receive them, so I can't say exactly, but that's.
[CUSTOMER][POSITIVE] Yes, yes, uh, of course, of course, I love.
[AGENT][POSITIVE] And you can even check claim status online too.
[CUSTOMER][NEUTRAL] Yes ma'am, mhm, uh, I have seen some claims and then also what I saw was, um, perhaps the day the service would be, um, April, let's just say, and then I would see that it was processed April, May to July, like July or August.
[CUSTOMER][NEUTRAL] Like that that it would take like months so I'm not sure whether or not we have you you guys pay ID maybe um maybe we're filing electronically as a generic and perhaps it's being mailed, you know, to the mail system instead of the electronic.
[AGENT][POSITIVE] Wow.
[AGENT][NEUTRAL] Yeah, well, you want me to give a, do you, I can give you our fax number that way you have it on hand if nothing else, you can always fax it.
[CUSTOMER][NEUTRAL] Uh, not sure.
[CUSTOMER][NEUTRAL] OK, you did, you did, I think you did though you said [PII]?
[AGENT][NEUTRAL] That is it.
[CUSTOMER][NEUTRAL] Right, OK, we got that just in case, but you want me to just wait to um.
[CUSTOMER][NEUTRAL] Uh, and call you back maybe tomorrow to see if the claim, see if you got this claim that I just did on the portal.
[AGENT][POSITIVE] You can if you want to and anybody will be happy to check that for you.
[CUSTOMER][NEGATIVE] Oh, OK, it might not be you. I don't, I don't even talk to nobody else what.
[AGENT][NEUTRAL] It might not be me.
[AGENT][NEUTRAL] But it might be me too. You never know.
[CUSTOMER][NEGATIVE] What? Look, tell [PII] I do not want to talk to her. No, I'm just kidding. I don't even know who [PII] is.
[AGENT][NEUTRAL] [PII] is one of our representatives.
[CUSTOMER][NEGATIVE] You kidding? Are you kidding?
[AGENT][NEUTRAL] Mm mm mm, we have a.
[CUSTOMER][NEGATIVE] Stop [PII], stop it.
[AGENT][NEUTRAL] Mhm. We have a uh a representative named [PII].
[CUSTOMER][NEUTRAL] Well, I didn't mean that. No, I'm gonna say, well, tell [PII].
[AGENT][POSITIVE] No, I know you didn't cause she's good.
[AGENT][NEUTRAL] Yeah, we don't have a [PII]. There you go.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, well thank you. Do I have a reference number for this call?
[AGENT][NEUTRAL] You would choose my name in today's date.
[CUSTOMER][NEUTRAL] At today's date, OK, and I'm gonna call one of you guys tomorrow just to see um.
[AGENT][NEUTRAL] Just to make sure.
[CUSTOMER][NEUTRAL] And OK and should I.
[CUSTOMER][NEUTRAL] Regard the uh reference number or that confirmation number that the claim was uploaded successfully which one should I use? Either either.
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] It would be the confirmation number for claim just to see if we've received it or you can just tell say hey I've I've uploaded a claim yesterday and just wanna make sure that you received it.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK, got
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, got you. Alright, simple and simple and plain. OK, got you. You have a good night because I only have uh 24 minutes. I'm not sure how you got right.
[AGENT][NEUTRAL] And that'll be fine too.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] I hope you do too.
[AGENT][NEGATIVE] OK, now you're making me jealous.
[AGENT][NEUTRAL] I got about 2 hours left, but that's fine.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh no, where are you? What time zone are you in?
[AGENT][NEUTRAL] I'm in [PII].
[CUSTOMER][NEUTRAL] Oh, you know what, your accent is not heavy at all. You have a very professional voice. It, it slipped up, it slipped out a little bit, but I just think uh it, you know, all of us are I'm from [PII] and they'll say, oh well, oh, your accent is heavy, but I think I sound like a Southerner sometimes.
[AGENT][POSITIVE] Well, thank you.
[AGENT][NEUTRAL] See, I didn't hear a heavy [PII] accent.
[CUSTOMER][POSITIVE] Hey, good j[PII], good job. Thank you, ma'am. Talk, talk to you tomorrow, [PII].
[AGENT][NEUTRAL] That's right. Well, you know.
[AGENT][POSITIVE] All [PII]. I hope you have a lovely evening, [PII]. It's such a pleasure to assist you. Take care.
[CUSTOMER][POSITIVE] You too now bye bye. Yes it was thank you ma'am.
[AGENT][POSITIVE] Thank you. Bye bye.