AccountId: 011433970860
ContactId: 6208c8ac-e029-4123-aa8c-afc44a1593a7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 865859 ms
Total Talk Time (AGENT): 265159 ms
Total Talk Time (CUSTOMER): 147855 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/6208c8ac-e029-4123-aa8c-afc44a1593a7_20250326T18:09_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's [PII]. I'm calling from a provider's office to follow up on a patient's claim, please.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with claim status. Can you please give me your callback number?
[CUSTOMER][NEUTRAL] Call back [PII] direct.
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Her date of birth is [PII].
[CUSTOMER][NEUTRAL] And the policy number I have is 1266106.
[AGENT][NEUTRAL] OK, let me pull up her policy number real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then can you give me the data service and the charge amount?
[CUSTOMER][NEUTRAL] Sure, the data service is going to be 82624.
[CUSTOMER][NEUTRAL] And the charge is $17,041.50.
[AGENT][NEUTRAL] OK, and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] $1,071.91 for the coinsurance.
[AGENT][NEUTRAL] OK and then can you give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Sure. It's going to be East Georgia Regional Medical Center.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look this claim up for us, Ms. [PII], and I'll be right back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, Ms [PII], this is [PII] back with you again.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I do um have the claim on file. The claim number is 355-0802.
[AGENT][NEUTRAL] Uh, the claim is under policy number.
[AGENT][NEUTRAL] 1456248.
[AGENT][NEUTRAL] And it has a remark on here that I need to let you know about um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] We have, uh, we are unable to assign benefits to the provider of record due to a discrepancy with the provider's tax ID number. A letter has been mailed to the provider with instructions on resolving the discrepancy.
[AGENT][NEUTRAL] The provider will need to resolve the dis the discrepancy with our office to resume receiving communications regarding claim decisions and benefit payments. Our claim decision, including any payable benefits for this charge, has been sent to the insured. Please contact our office with any questions.
[CUSTOMER][NEUTRAL] So was the payment, so uh was any no payment was sent out then, right?
[AGENT][NEUTRAL] No payment was sent out to the provider because there's a discrepancy in the provider's tax ID number.
[AGENT][NEUTRAL] And a letter was sent.
[CUSTOMER][NEUTRAL] OK. Was anything sent to the patient?
[AGENT][NEUTRAL] Uh, it says our claim decision including any payable benefits for this charge has been sent to the insured.
[CUSTOMER][NEUTRAL] OK, so we don't know if the if the payment of $1,0071.91 that was sent to [PII].
[AGENT][NEUTRAL] Right, I can't give how much information, how much money was sent to her. All I could do is just read the remark that the charge was sent to the insured.
[CUSTOMER][NEUTRAL] OK, so let's get back to the tax ID. Yeah. What's the issue with the tax ID?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] It doesn't tell me what it is. It just says the letter has been mailed to the provider which is.
[AGENT][NEUTRAL] Medical center
[CUSTOMER][NEUTRAL] When was the letter sent to the provider?
[AGENT][NEUTRAL] Uh, let me see, this was done on.
[AGENT][NEUTRAL] Let me see what day it was processed.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] OK, let me check to see if we received anything.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, we don't have anything from APL at all from them about that. Do you have a if you have a copy of the letter?
[AGENT][NEUTRAL] Let me look and see real quick.
[CUSTOMER][NEUTRAL] OK, because we need to know what's going on with it, why it's not.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Right, I understand. Uh, let me see. I'm gonna put you on a quick hold to see if I can find it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, thank you very much Ms. [PII] for holding for me. So I can't give out any information about it, but what I've been instructed to do is take your name and your number and send an email.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] To our administration so that they can return the call and answer all your questions.
[CUSTOMER][NEUTRAL] OK, so you don't have a copy of the letter.
[AGENT][NEUTRAL] I can't see a copy of the letter it's under the provider information and I can't get to provider information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so is this phone number that you gave me the [PII], is that a good number?
[AGENT][NEUTRAL] To return the call to?
[CUSTOMER][NEUTRAL] Yeah, that's direct to my direct line. mhm, direct and my voicemail is secure to leave a message and I'm gonna need to provide you the patient's um account number for uh East Georgia Regional so they can refer to that when they call back.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, what is that, please?
[CUSTOMER][NEUTRAL] It's um 724-075-2.
[AGENT][NEUTRAL] OK, and that's the patient account number for Georgia Region, OK.
[AGENT][NEUTRAL] Alright, I've got that down. I'm gonna put you on a quick hold while I get that email together in case I have any other questions to ask.
[CUSTOMER][NEUTRAL] OK, so you're gonna put a request in from someone from provider relations to call me back?
[AGENT][NEUTRAL] No, I'm gonna put a request in for somebody from administration to call you back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's gonna be a brief hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, Miss [PII], do you have an email address?
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] OK, what is that please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And then [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My last name is [PII]. It's [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And then [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold again while I finish this email I'll be right back.
[CUSTOMER][NEUTRAL] Thank you. You are on hold.
[AGENT][NEUTRAL] Hm.
[AGENT][NEGATIVE] Oh, come on.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you, Ms. [PII], for holding for me. I've got that email sent now and you should be receiving a call within 24 hours from somebody from the administration department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, is there any way that we can send a W-9 over or you're not sure about that?
[AGENT][NEUTRAL] I'm not sure. I don't, it, it did not give me any instructions as to what to do to follow up um for this, but um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But when somebody calls you back, I'm sure, yes, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] Alright, I'll just take a reference number.
[CUSTOMER][NEUTRAL] Yeah. OK.
[CUSTOMER][NEUTRAL] OK, the call back is usually what, like 3 days or?
[AGENT][NEUTRAL] Uh, it's with, yes, it should be between 24 hours and 3 days. Yes, ma'am.
[CUSTOMER][NEUTRAL] Do you know how, how long?
[CUSTOMER][POSITIVE] OK all right thank you have a good day.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Thank you for calling APL. You have a great day also.
[CUSTOMER][POSITIVE] You too, thanks. Bye-bye.
[AGENT][NEUTRAL] Bye bye.