AccountId: 011433970860
ContactId: 6da4fb34-b409-4e34-81b1-8c687c1b290f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 494350 ms
Total Talk Time (AGENT): 160225 ms
Total Talk Time (CUSTOMER): 172158 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/6da4fb34-b409-4e34-81b1-8c687c1b290f_20250214T15:57_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm from Northwest Community Hospital. We received a check from you and we can't identify the account number or the patient that you've got on the EOB.
[AGENT][NEUTRAL] What's the check number, [PII]?
[CUSTOMER][NEUTRAL] It is 202-528-0.
[AGENT][NEUTRAL] And the amount of the check?
[CUSTOMER][NEUTRAL] $124.35.
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that information, give me one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Still looking.
[CUSTOMER][NEGATIVE] Yeah, the account number that you have on here isn't like an account number that we use and I can't even find the patient by that name.
[AGENT][NEUTRAL] And what office are you calling on behalf of?
[CUSTOMER][NEUTRAL] I'm from Northwest Community Hospital.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Alright, so I have located the patient information. I'm showing the claim was from Northwestern Community Hospital and the payment is 124.35. I'm showing the patient as [PII].
[AGENT][NEUTRAL] [PII] is the last name.
[CUSTOMER][NEUTRAL] OK, wait, let me try typing this [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And then [PII]
[CUSTOMER][NEUTRAL] Nope, we don't have a patient by that name. You said Northwestern Community Hospital?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] We're Northwest Community Hospital.
[AGENT][NEUTRAL] Mm it's Northwest. It says Northwest Community Hospital.
[CUSTOMER][NEUTRAL] What kind of address do you have?
[CUSTOMER][NEUTRAL] OK, what address do you have on that claim or is there a
[CUSTOMER][NEUTRAL] Our um numbers start with.
[AGENT][NEUTRAL] Verify your billing
[AGENT][NEUTRAL] Verify your billing address.
[CUSTOMER][NEUTRAL] Uh, this came to [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Um, our other address, the actual hospital address is [PII].
[AGENT][NEUTRAL] What's the billing address on this particular claim? Is it the [PII]?
[CUSTOMER][NEUTRAL] Illinois 6
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so this is, of course you got the check that's where it was mailed to and let's see.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] You actually have a claim?
[AGENT][NEUTRAL] I do based on the check number that you gave me.
[CUSTOMER][NEUTRAL] OK, our, our claim numbers start with an H. It's like.
[CUSTOMER][NEUTRAL] H blah blah blah.
[AGENT][NEUTRAL] Yeah, so the claim number from APL would be different.
[CUSTOMER][NEUTRAL] OK, because we have another EO we got two payments from you on the same day and the other one has the patient account number as the.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] On the EOB it says patient account number. The other one starts with an H.
[CUSTOMER][NEUTRAL] And gives us our number and we identified that this says LAGP don't even know what that is.
[AGENT][NEUTRAL] The explanation of
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so when you say the LAGP, are you referencing that to the charge, the, the payment of 12435?
[CUSTOMER][NEUTRAL] Yeah, it, it's on your EOB it says date of service [PII] and then it says patient account number LAGP.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Let me pull the CMS 1500 form. Is this an anesthesiologist charge?
[CUSTOMER][NEUTRAL] 23899.
[CUSTOMER][NEUTRAL] I have no idea. Uh, we don't bill for anesthesiologists, so I'm wondering if it went to the wrong.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Person.
[AGENT][NEUTRAL] Yeah, give me one second.
[CUSTOMER][NEUTRAL] Unless it was
[CUSTOMER][NEUTRAL] Unless you can give me an age number.
[AGENT][NEUTRAL] Bear with me here.
[AGENT][NEGATIVE] It looks like this um may have been sent to the incorrect.
[AGENT][NEUTRAL] Health care provider?
[AGENT][NEUTRAL] And looking at the CMS 1500 claim form, um, so has that check been cashed?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, because it went directly to our bank.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] Was it provided at Northwest Community Hospital?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEGATIVE] OK, no wonder I can't find the person like I got nothing on this.
[AGENT][NEUTRAL] So that's why give, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So what we will do, um.
[AGENT][NEUTRAL] We will send a letter to your location at Northwest Community Hospital, the address that was verified, and we'll need to request a refund for that amount.
[AGENT][NEUTRAL] Um,
[AGENT][NEGATIVE] It was sent to this location in error.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I can send also a um request to our refund department for them to refund it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, should they be putting on there who it should have gone to or anything or?
[AGENT][NEUTRAL] No, um, and just for, you know, tracking purposes we will we will mail out a letter, a refund letter to the, uh, to Northwest, uh, community, uh, to the address that you verified, um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] With instructions um of of what to do.
[AGENT][NEUTRAL] And however you all choose to do it internally it is up to you but we will send out a letter.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, so it wasn't anything at Northwest Community, so I can just, OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Correct. Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. And is there a reference number?
[AGENT][NEUTRAL] You'll use my name in today's date as reference for today's call. It's [PII].
[AGENT][NEUTRAL] O N Y A
[AGENT][NEUTRAL] [PII] then [PII] of [PII] last [PII] is [PII], did you have any other questions?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK, well thank you for calling APL have a good day.
[CUSTOMER][POSITIVE] Thank you, you too.
[AGENT][NEUTRAL] Uh-huh, bye-bye.
[CUSTOMER][NEUTRAL] Bye.