AccountId: 011433970860
ContactId: 62840bec-e20a-440f-8326-f5d14406975d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 705880 ms
Total Talk Time (AGENT): 242315 ms
Total Talk Time (CUSTOMER): 154941 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/62840bec-e20a-440f-8326-f5d14406975d_20250306T14:25_UTC.wav
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[AGENT][NEUTRAL] Morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi there, my name is [PII], and I'm calling with Saint Mary's Regional regarding claim status for a mutual member.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK, yes ma'am I can help you with that and what is a good call back number for you please?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number, please, [PII].
[CUSTOMER][NEUTRAL] Sure, that's 02555592.
[AGENT][NEUTRAL] Thank you. One moment please while I get the member's information pulled up.
[AGENT][NEUTRAL] And any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name, please, [PII], and their date of birth?
[CUSTOMER][NEUTRAL] Yes, I have [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And what is the data service and total bill amount for her place?
[CUSTOMER][NEUTRAL] I have [PII] of this year, and that is for the amount of $28,289.98.
[AGENT][NEUTRAL] So let's see, let me go back here. So this was from [PII], is that correct?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes mhm.
[AGENT][NEUTRAL] OK, and the bill amount one more time please, 24.
[CUSTOMER][NEUTRAL] 28
[AGENT][NEUTRAL] 0, 28.
[CUSTOMER][NEUTRAL] So it's 28, yes ma'am, $28,289.98.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] I'm so sorry about that.
[CUSTOMER][POSITIVE] You're OK.
[AGENT][NEUTRAL] Alright, bear with me just a moment. I need to look at a few things on this.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry this is taking so long, but I'm just having a look at a few things.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so now I do see that there was.
[AGENT][NEUTRAL] The claim was received.
[AGENT][NEUTRAL] For this data service for that build amount.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Now on the information.
[AGENT][POSITIVE] I do apologize. I'm just, my screens are moving pretty slowly for me this morning.
[AGENT][NEUTRAL] OK, so it was 220.
[AGENT][NEUTRAL] [PII] and processed on [PII].
[AGENT][NEUTRAL] The claim number that was assigned is 356-688-8.
[AGENT][NEUTRAL] And again, it was denied and according to the information, um.
[AGENT][NEUTRAL] I would.
[AGENT][NEGATIVE] It was denied due to a discrepancy.
[AGENT][NEUTRAL] It says that 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. The provider will need to resolve the discrepancy with our office to resume receiving communications regarding claims decisions and benefit payments.
[AGENT][NEUTRAL] Our claim decision including any payable benefits for this charge has been sent to the insured, please contact you with any questions.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yes, so we did receive that letter, um, as I in we faxed the letter, faxed the claim, and faxed the W-9 form, um, to the claims fax number on there which was [PII]. we faxed that on this on [PII] of this year.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, to that fax number, the information.
[AGENT][NEUTRAL] OK, now I do not see, let me go back and look again at this stage.
[CUSTOMER][NEGATIVE] And it should have been a total of 4 pages um in that fax.
[AGENT][NEUTRAL] Now what I can do is I there is someone that I can email to um.
[AGENT][NEGATIVE] I have returned the call to you, but I do not see that that has been received.
[CUSTOMER][NEUTRAL] OK, but you received documents on [PII] because I know you said the claim was received on [PII]. Um, so that it sounds like something was received on the same day we faxed it. Now it's all in, you know, we faxed everything together. So hopefully that whoever received that, um, they were able to scan everything in together, you know, so it didn't be no um confusion.
[AGENT][NEUTRAL] Uh-huh. Right.
[AGENT][NEUTRAL] OK, give me just a moment to see if I can.
[AGENT][NEUTRAL] Yes, I'm not, I'm so sorry but I'm not able to access that information. Now I'll be happy to um send an email with your information with your contact information.
[AGENT][NEUTRAL] And have the person that would handle this to give you a call back if you would like for me to do that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, that'd be great thank you.
[AGENT][NEUTRAL] OK. You're welcome. So, um, what is, um, so the [PII] is the best contact number, is that correct?
[CUSTOMER][NEUTRAL] You can actually call me directly um I have a main line of [PII].
[CUSTOMER][NEUTRAL] That's new extension.
[AGENT][NEUTRAL] OK, that's [PII].
[AGENT][NEUTRAL] Give me the last 11 more time.
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I might need to start my day over again, [PII]. It's I'm struggling a lot today. [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And what department are you in, [PII]?
[CUSTOMER][NEUTRAL] This is the patient accounts department.
[AGENT][NEUTRAL] Patient accounts, OK, and then what is the first initial to your last name?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Absolutely it's [PII]
[AGENT][POSITIVE] OK. All right. Well, I will be happy, um.
[AGENT][NEUTRAL] To take down the providers, I mean to send this email regarding this.
[CUSTOMER][NEUTRAL] OK, yes.
[AGENT][NEUTRAL] And uh
[AGENT][NEUTRAL] Is there anything else, [PII] that I can help you with at the moment?
[CUSTOMER][NEUTRAL] Um, no, what do you know who I should be expecting a response from, or is it just like, just anyone who's assigned to it or?
[AGENT][NEUTRAL] Well, I believe that it would be [PII].
[CUSTOMER][NEUTRAL] How does that normally?
[CUSTOMER][NEUTRAL] [PII], OK. OK, thank you.
[AGENT][POSITIVE] Yes, ma'am. Uh-huh. And she will give you, uh, you know, and I will ask her to give you a call back.
[CUSTOMER][POSITIVE] Awesome sounds great thank you again. Yes, ma'am, and do you normally provide reference numbers for the calls?
[AGENT][NEUTRAL] OK, all right.
[AGENT][NEUTRAL] Yes, ma'am, you would just use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] OK, thank you again, Miss [PII], and I hope you have a great rest of your day.
[AGENT][NEUTRAL] OK, well.
[AGENT][POSITIVE] Uh yes ma'am I hope you do too, and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you, take care.
[AGENT][NEUTRAL] All right, you