AccountId: 011433970860
ContactId: 728d578c-70b4-4504-9c7b-a2f45cdbde19
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 4392100 ms
Total Talk Time (AGENT): 1376136 ms
Total Talk Time (CUSTOMER): 2065581 ms
Interruptions: 20
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/728d578c-70b4-4504-9c7b-a2f45cdbde19_20250227T17:15_UTC.wav
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[AGENT][POSITIVE] And thank you for calling the APL. My name is [PII]. How may I help you?
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. I'm sorry for that. Uh, so my name is [PII]. My last initial is [PII], and I was speaking with my mic muted. I'm sorry for that.
[AGENT][POSITIVE] That's all right. It's easy to do. How can I help you today, [PII]?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Uh, for today's call, I would like to check the status of your of the claims with me.
[AGENT][POSITIVE] Well, it would be my pleasure, and [PII], what is a good callback number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Policy number, it is 02462791.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] So, the patient's name is uh [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] And it would be my pleasure to assist you with claim status today. Do you have a data service or claim number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I do have the date of service and uh for today's call, I, I would like to request you to fax me all the UOBs to me because I was trying to uh download the EOBs, but in my system that shows some errors here. So, uh can you fax me the UOB as well?
[AGENT][NEUTRAL] Yeah, let's try getting those, uh, do you have an account online?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Yes, I do have it.
[AGENT][NEUTRAL] OK, let me give you the claim number and see if you can't get it because if you can you don't have to wait for the fax back but I can provide the claim numbers and let's see if that will come up for you, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Mm OK. Thank you so much for that.
[AGENT][POSITIVE] My pleasure. And what is the data service?
[CUSTOMER][NEUTRAL] The service is [PII].
[AGENT][NEUTRAL] And what is the bill amount and facility name?
[CUSTOMER][NEUTRAL] This amount is $184 even facilities name it's Mercy Clinic.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][POSITIVE] Mhm. You're welcome.
[AGENT][NEUTRAL] And I do have that claim pulled up. Let me give you the claim number and see if you can pull it up in the portal.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 348.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 0425.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK. Let me check that so that I can pull up the UP.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is loading. Yes, there is an EOB.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Now, uh, so actually, uh, it shows the pop up like it it appears your document is missing. Claim, uh, APL claims has been notified. Please allow 48 hours for the document to be available online. It is the thing I have been receiving for the past half an hour, I think so.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bear with me just one second.
[CUSTOMER][POSITIVE] OK, no issues. Take your time.
[AGENT][NEUTRAL] I can fax it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If I can get it to come up, bear with me, and it may just be that they're working on the website, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Sometimes when they're working on it, it does pop up with errors.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEGATIVE] OK. Even for yesterday, I did like face some issues uh regarding the port also for the same time, I guess, so even today it is facing the same problem here. Yeah.
[AGENT][POSITIVE] Oh, I am so sorry.
[AGENT][NEUTRAL] I'm not sure why it state and you, you put in the patient's first name and date of birth?
[CUSTOMER][NEGATIVE] Yes, I have been filled all the information and even in the morning, I have been working with the APL. It was working no good. There is no clashes there. But in the, in the time right now, we are, we are talking, I have been uh facing the same issue even in yesterday.
[AGENT][POSITIVE] Oh, I am so sorry.
[CUSTOMER][NEUTRAL] Mm. No, it's just that.
[AGENT][NEUTRAL] Well, I
[AGENT][NEUTRAL] What is the fax number?
[CUSTOMER][NEUTRAL] It is [PII]. And the attention is my name with my last initial, tell you, sir.
[AGENT][NEUTRAL] And what is that last initial?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you. And do you spell your name with an [PII]? OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] And just to verify that I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] And can I also
[CUSTOMER][NEUTRAL] Mhm and then I'll go ahead.
[AGENT][NEUTRAL] Yeah just to verify that fax number, I'm sending this EOB to [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, it's absolutely correct. You've got it correct.
[AGENT][NEUTRAL] All right. Well, [PII], that EOB is on the way.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][POSITIVE] You should be receiving it shortly. You're welcome.
[CUSTOMER][POSITIVE] Mhm. Thank you so much for that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And yeah, uh for the claim, can I have the receipt date process date?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Receipt date was [PII] and processed on [PII]. The claim was denied as office visits are not covered under the patient's plan.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. Uh, may I know what type of plan that patient has?
[AGENT][NEUTRAL] It is a secondary Medlink gap policy.
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] So meddling gap will not cover office visit, right?
[AGENT][NEGATIVE] This policy does not. Some do, but this policy does not.
[CUSTOMER][NEUTRAL] OK. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Give me a minute. Let me document it and come with the next information.
[AGENT][NEUTRAL] Is it, will it, will it be for a different patient or the same patient, or do you know?
[CUSTOMER][NEUTRAL] Different, different patients.
[AGENT][POSITIVE] OK, I can go ahead and get ready for that.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm. Yeah, sure.
[AGENT][POSITIVE] And I'm ready whenever you are.
[CUSTOMER][POSITIVE] OK. Thank you so much for being patient. Just give me a minute. My system is loading here.
[AGENT][NEUTRAL] You're fine.
[AGENT][POSITIVE] You're fine. Take your time.
[CUSTOMER][POSITIVE] Thank you so much for the understanding, [PII].
[AGENT][POSITIVE] I do understand for sure.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, so I'm ready with the next number here. So it is 019.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name is [PII] and uh date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][POSITIVE] And what is that? Oh, it's going well, thank you. How about you?
[CUSTOMER][NEUTRAL] And how was your day?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Mhm. My is going well. Good as well. Thank you for asking. And the date of service, date of service, it is [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that bill amount?
[CUSTOMER][NEUTRAL] $129 even.
[AGENT][NEUTRAL] And what is that facility name?
[CUSTOMER][NEUTRAL] It is the Mercy Clinic.
[AGENT][NEUTRAL] OK, thank you. Would you like that claim number just to see if you can pull this one up under this uh tax ID?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes, sure.
[CUSTOMER][NEUTRAL] I can try it.
[AGENT][NEUTRAL] That claim number is 319.
[AGENT][NEUTRAL] 9027.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 9027. OK, let me try to pull this one as well.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, can you repeat the claim number again? Uh I think I have, uh,
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Noted it incorrectly.
[AGENT][NEUTRAL] It is 319.
[AGENT][NEUTRAL] 9027.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] That is the claim number which I have put in, but it shows there is no claim to display.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Well, I'm on that.
[CUSTOMER][NEUTRAL] I think there is something, mhm I think there is something um wrong with in my end maybe or in the portal server or anything it can be.
[AGENT][NEUTRAL] Yeah, I think there's an issue.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because if, if I can find the the explanation of benefits in my system, you should be able to as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So there must be an issue going on.
[CUSTOMER][POSITIVE] Mhm. Yes, I do understand it. Thank you for the patience.
[AGENT][NEUTRAL] Um,
[AGENT][POSITIVE] Oh, sure, and thank you and we do apologize for any inconvenience. Let me get this received date and information for you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Mhm. Yes, sure. I'm ready for it.
[AGENT][NEUTRAL] That claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] And it was denied as office visits are not covered.
[CUSTOMER][NEUTRAL] OK, the thing.
[AGENT][NEUTRAL] Mhm. Mhm.
[CUSTOMER][NEGATIVE] Because I have been working for the same denial for the past 2 to 3 days.
[AGENT][NEUTRAL] And that EOB is, has been faxed to you. It's on the way.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You said the claim number was uh
[CUSTOMER][NEUTRAL] 319-9027, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK, thank you so much. Then,
[CUSTOMER][NEUTRAL] I will open the next claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And I'm ready whenever you are.
[CUSTOMER][NEUTRAL] Oh yes, it's on the way.
[AGENT][NEUTRAL] Can't hurry computers, can we?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You just have to wait.
[CUSTOMER][POSITIVE] No, I'm yeah, yeah. Thank you so much for your patience. It's been really, uh, I mean, could you see some of the representatives like as patient as you are. You're the first one I see, so that's fine. OK, so, mhm.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Well, you know, we, we have to all work together, you know, we're
[CUSTOMER][NEUTRAL] Yes
[AGENT][POSITIVE] And help each other.
[CUSTOMER][POSITIVE] Yes, thank you so much for your understanding. I really appreciate it. Keep it up for that.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] You're welcome. And then, and that policy number?
[CUSTOMER][NEUTRAL] Yes. It is 01707553.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I have to tell you, [PII], if you're a pleasure to assist, so.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much for that as well.
[AGENT][NEUTRAL] Mhm. And what is this patient's name and date of birth?
[CUSTOMER][NEUTRAL] This patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And what is that data service?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And that bills them out.
[CUSTOMER][NEUTRAL] $129 even.
[AGENT][NEUTRAL] Same provider?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because
[AGENT][NEUTRAL] That claim we received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Process on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And denied as.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Can you guess what it's denied as?
[CUSTOMER][NEUTRAL] Yes, it is office is it not covered right since the C.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] You are right.
[CUSTOMER][POSITIVE] Yes. Yes, thank you so much. And can I have the claim number?
[AGENT][NEUTRAL] And let me
[AGENT][NEUTRAL] That claim number is 320.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 3889 and this one's taking a little.
[CUSTOMER][NEUTRAL] 38.
[AGENT][NEUTRAL] Yeah, it's gonna take me a minute to get this EOB to fax. It's taking a minute to come up.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm mhm.
[CUSTOMER][POSITIVE] OK, no issues. You can definitely take your time.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Mhm. You're welcome.
[CUSTOMER][NEUTRAL] No
[AGENT][NEGATIVE] Oh, this one's taken a long time. Hang on just a second.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, no issues. I really understand it and appreciate it. No issues. You can take your time, definitely.
[AGENT][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] to
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I got it.
[CUSTOMER][NEUTRAL] That
[AGENT][POSITIVE] All right, that one is on the way as well.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Mhm. Thank you so much.
[AGENT][POSITIVE] And I'm ready for the next one. How many do you have?
[CUSTOMER][NEUTRAL] I have uh like uh more than 20, but I, yeah, and if you can, I can, I can find the exact number. It is like [PII], 1213, 14.
[CUSTOMER][NEUTRAL] It's like uh 15 to 20.
[AGENT][NEUTRAL] A lot.
[AGENT][NEUTRAL] OK. All right. What's the next one?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, the next one is 021.
[CUSTOMER][NEUTRAL] 23962.
[AGENT][NEUTRAL] And that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, and date of service?
[CUSTOMER][NEUTRAL] Date of service, it is [PII].
[AGENT][NEUTRAL] And build on.
[CUSTOMER][NEUTRAL] $260 even.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Mhm. You're welcome.
[AGENT][NEUTRAL] Now this claim we received.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And processed on 12-9-22.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And there was a payment of $75 sent to Mercy Clinic, Oklahoma.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Uh, so, uh, I can see that information here that it was paid and that there was a not allowed amount of $185 and there is no remark code on this. Uh, so, uh, can you, uh, tell me what was the balance amount is for?
[AGENT][NEUTRAL] So we're not
[CUSTOMER][NEUTRAL] Is that a contractual adjustment?
[AGENT][NEUTRAL] There's no contractual involvement in the processing of this claim. Any patient responsibility is determined by the provider.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, so it is neither a patient's responsibility or a contractual adjustment from your end, right? It can be decided by the provider.
[AGENT][POSITIVE] That is correct.
[AGENT][POSITIVE] Yes, ma'am, that's right.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. Let me make note of it.
[CUSTOMER][NEUTRAL] Give me a moment.
[AGENT][NEUTRAL] And that EOP is on the way.
[CUSTOMER][POSITIVE] Mhm. Thank you so much.
[CUSTOMER][NEUTRAL] Is that the claim number on 23229668?
[AGENT][NEUTRAL] It is.
[CUSTOMER][POSITIVE] OK. Thank you so much for that.
[CUSTOMER][NEUTRAL] Be
[AGENT][POSITIVE] And I'm ready for the next one whenever you are.
[CUSTOMER][POSITIVE] Yes, sure. Thank you so much for being impatient.
[CUSTOMER][NEUTRAL] I'm looking into the next claim.
[AGENT][NEUTRAL] If you have a claim number, I can look everything up by the claim number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And now, actually, that is the first time I had a claim number.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm. And yeah, if I have the claim number, I will provide you with it, OK? Then we can go by the claim number. It will be easy for both of us, right?
[AGENT][NEUTRAL] OK. All right.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] OK. So the next policy number, it is 01792144.
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] And date of service.
[CUSTOMER][NEUTRAL] Date of service, it's [PII].
[AGENT][NEUTRAL] And build out.
[CUSTOMER][NEUTRAL] Bill amount $129 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Trying to get that see date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Sorry about that. It's just taking me a minute to locate the.
[CUSTOMER][POSITIVE] Mm. Mhm. No issues. Mhm.
[AGENT][NEUTRAL] Receive me.
[AGENT][NEUTRAL] OK, that claim was received on.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Now, it was denied.
[CUSTOMER][NEUTRAL] Offices is not covered, right?
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] OK. Mm.
[AGENT][NEGATIVE] My computer is going a lot slower, hang on.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] No issues. We can take your time as the same thing. We cannot urge the computer, right? We can pay for it.
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] That claim number, you ready?
[CUSTOMER][POSITIVE] Yes, I'm ready.
[AGENT][NEUTRAL] That claim number is 325.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 743 5.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][NEUTRAL] And getting that EOB.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right, [PII], that is on the way for you.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And I'm ready for the next one.
[CUSTOMER][NEUTRAL] OK. The next one, it is 1,462,660.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] Name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] D of service, it is [PII].
[AGENT][NEUTRAL] And build out.
[CUSTOMER][NEUTRAL] $184 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] That claim we received on 224-23.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And processed on [PII] I can't say it 3223.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] 3223. OK.
[AGENT][NEUTRAL] Now,
[AGENT][NEUTRAL] Right. Now, this claim was denied as the services were rendered after the policy termed.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK. Uh, give me a minute.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh may I know uh what was the patient's effective and term date?
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] Yes, the effective date.
[AGENT][NEUTRAL] Is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And termed on [PII].
[CUSTOMER][NEUTRAL] [PII]. And can you check is there any um coverages active for the data of service?
[AGENT][NEUTRAL] Not with APL.
[CUSTOMER][NEUTRAL] OK. There is no other coverages active for the data of service at the APL, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK. Thank you so much for that.
[CUSTOMER][NEUTRAL] Uh, give me a minute. So, uh,
[CUSTOMER][NEUTRAL] But here, uh, one of my previous colleague has spoke on [PII] and they are stating that the claim was denied for um office visits are not covered.
[AGENT][NEUTRAL] Did they have a claim number?
[CUSTOMER][NEUTRAL] Mhm. Oh, they don't have it and I'm sorry. I think they have gotten incorrect information because the date of service is [PII], and they have mentioned it as uh they have received the claim in [PII] maybe they have put it in incorrect.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I'm sorry for that.
[AGENT][POSITIVE] Yeah, that might be a problem. No problem.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Mhm, thank you so much for that. And can I have the claim number for that?
[AGENT][NEUTRAL] 326-52007 and that EOB is on the way.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you so much for that.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] And I'm ready whenever you are.
[CUSTOMER][NEUTRAL] OK, I totally forgot to pull up the claim I.
[AGENT][POSITIVE] Just wanna let you know I'm ready whenever.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][POSITIVE] Thank you so much for your patience.
[CUSTOMER][NEUTRAL] That's.
[AGENT][POSITIVE] Not a problem.
[CUSTOMER][NEUTRAL] OK, here it is.
[CUSTOMER][NEUTRAL] Mm, OK, got it. So, uh, the next, uh, member ID is 1462902.
[AGENT][NEUTRAL] And name and date of birth.
[CUSTOMER][NEUTRAL] Name [PII] and uh date of birth is [PII].
[AGENT][NEUTRAL] And data service?
[CUSTOMER][NEUTRAL] Date of service, it is [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][POSITIVE] Getting that received it for you.
[CUSTOMER][NEUTRAL] Mm mhm. Yes.
[AGENT][NEUTRAL] This claim we received on 3-2223.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Processed on [PII] and denied.
[AGENT][NEUTRAL] And this is not covered. You're right.
[CUSTOMER][NEGATIVE] Yes, also this are not covered.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Great
[AGENT][POSITIVE] I love it.
[CUSTOMER][POSITIVE] And I'm ready mhm and I'm ready for the claim number.
[AGENT][NEUTRAL] The claim number is 327.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] 763 2.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] 32. Great. Thank you so much. And uh next patient.
[AGENT][NEUTRAL] Let me get the COB, bear with me just a second.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Mhm. No issues. Take your time.
[CUSTOMER][NEUTRAL] In the meantime, I will also put the patient here.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] I had a lot of.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] OK, I'm ready.
[CUSTOMER][NEUTRAL] Mm, OK. So the next patient's member ID is 01654347.
[AGENT][NEUTRAL] Name and date of birth.
[CUSTOMER][NEUTRAL] Name [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And data service.
[CUSTOMER][NEUTRAL] Date of service? Yes, it's [PII].
[AGENT][NEUTRAL] Hm, [PII]. Hang on just a second. This policy turned on 12-121. Let me see if they have active coverage.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] or see if I can locate that policy or that claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, he had active coverage for that data service. Let me give you the correct policy number.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The correct policy number for [PII] for that data service is 211.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 354 9.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, noted that.
[AGENT][NEUTRAL] And that was active from.
[AGENT][NEUTRAL] 12 1 21 and turned on 7 123.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So for the data service of 41723, what's the billed amount?
[CUSTOMER][NEUTRAL] $168 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm checking for that claim, so bear with me.
[CUSTOMER][POSITIVE] Mhm. No issues. Take your time. That is definitely OK for me.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] I'm checking.
[AGENT][NEUTRAL] And what was, what was that bill amount again for 4:17?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $168 even.
[CUSTOMER][NEUTRAL] Let me see if there is any claim number here.
[CUSTOMER][NEUTRAL] Mm no claim number.
[AGENT][NEUTRAL] Yeah, I'm not locating that claim on file.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] But, uh, upon checking here, my previous colleague has been found the check was issued to incorrect address and uh our representative uh suggested to, I mean, asked to reissue the payment to correct mailing address and the rep suggested also to submit a form to update the correct pay to address.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] And we have also submitted a double knife form.
[AGENT][NEUTRAL] Do you know what date that?
[AGENT][NEUTRAL] Um, representative spoke to us.
[CUSTOMER][NEUTRAL] Mhm. Yeah, I know. It was on [PII].
[CUSTOMER][NEUTRAL] Last month.
[AGENT][NEUTRAL] I don't see any notes in the system on this policy.
[CUSTOMER][NEUTRAL] Oh well.
[AGENT][NEUTRAL] Did, did they have the reference number?
[CUSTOMER][NEUTRAL] How come?
[CUSTOMER][NEUTRAL] Mhm. Yes, they do have it.
[AGENT][NEUTRAL] What's the reference number for that call?
[CUSTOMER][NEUTRAL] It was L as in Lima, I as in India, S as in Sierra, A as in Alpha, 01032025.
[AGENT][NEUTRAL] OK, let me check the other policy because I don't, did they have a claim number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, but they don't have any claim number.
[AGENT][NEUTRAL] Let me check that other policy, the lapsed policy.
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] Were they given the correct policy number for that data service?
[CUSTOMER][NEUTRAL] No, actually, since the representative has to reissue the um check, there is no other information regarding the claim is here.
[AGENT][NEUTRAL] I don't see any notes on that data service and they spoke to a representative at APL.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] And it was [PII], and I don't know of any [PII] in our claims department.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so, uh, you said, uh, this claim was, uh, not on file, right? For the data service and the bill amount, there is no claim on file, correct?
[AGENT][NEGATIVE] I, I'm unable to locate it.
[CUSTOMER][NEGATIVE] OK, you are unable to locate it.
[AGENT][NEUTRAL] Did, could that have been the primary insurance that the payment was paid?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, uh Blue Cross Blue Shield is the patient's primary insurance.
[AGENT][NEUTRAL] I wonder if that is who they spoke to because was it foreign offices at CPT?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, correct. No, no, uh, it was, no, no. This is for the radiology.
[AGENT][NEUTRAL] Cause this policy
[AGENT][NEUTRAL] OK, what's do you have that CPT uh CPT code? Let me see if I can pull it up by that.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK. It is 73564.
[AGENT][NEUTRAL] And what is the name of the provider?
[CUSTOMER][NEUTRAL] Provided, it's mostly clinic. You want the individual provider's name?
[AGENT][NEUTRAL] The, what is the um
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Billing provider name.
[CUSTOMER][NEUTRAL] Billing provider name is [PII].
[AGENT][NEUTRAL] Oh, there are 2
[AGENT][NEUTRAL] CPT codes?
[CUSTOMER][NEUTRAL] No, there is only one CPT code which is 7373564 with the modify of DC and 50.
[AGENT][NEUTRAL] Yeah, see, I, I do have a claim for that data service but not for that provider, not for that build amount.
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[CUSTOMER][NEUTRAL] OK, uh, not for the individual provider?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is that under the Mercy Clinic?
[AGENT][NEUTRAL] No, it's under a different, different provider. Do you have the tax ID number?
[CUSTOMER][POSITIVE] Mhm, yes, I do have it.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, we don't have a claim on file for that data service with that tax ID number. Now, it can be faxed to our claims department with the primary EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. What is the timely failing to submit the claim?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] OK, then we can form it right um.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] Great, thank you so much.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Great. Thank you so much.
[CUSTOMER][NEUTRAL] And yeah.
[AGENT][NEUTRAL] Do you want the um now we probably need to verify the claims mailing address.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes, I can also verify it. So give me a minute. I was just close the account here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] Or I can give you our claims fax number.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK. Is that, do you have the claims fax number?
[AGENT][NEUTRAL] I do. It is 877.
[CUSTOMER][NEUTRAL] Mhm. Oh.
[CUSTOMER][NEUTRAL] OK. Give me a minute.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. It's 877.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 9423. OK. Thank you so much for that. And uh I would also verify the mailing address. Which was the correct mailing address to submit the claim?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm. That is the mailing address which the claim is in. OK. No issues that we can resubmit the claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Thank you so much for that information, [PII].
[AGENT][POSITIVE] My pleasure, and I'm ready for the next one.
[CUSTOMER][NEUTRAL] OK. So the next one, yes, it's here. Next one, it is 01707553.
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] Name it is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] Date of service, yes, i[PII]'s [PII].
[AGENT][NEUTRAL] OK, let me check this policy as well, because this one turned on 3-123.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So let me see.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Yeah, let me give you the correct policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] As of 3123, the policy number is.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 232.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 0051.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is that bill amount?
[CUSTOMER][NEUTRAL] Uh the amount, yes, it is $121 even.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And let me check this, bear with me.
[CUSTOMER][POSITIVE] Mhm. No issues, take your time.
[AGENT][NEUTRAL] And did you call on this claim on [PII]?
[AGENT][NEUTRAL] Oh, that was a different thing that you called.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Um, this claim.
[AGENT][NEUTRAL] was
[AGENT][NEUTRAL] Received on [PII].
[AGENT][NEUTRAL] And processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And paid $46.24.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] To Mercy Clinic.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm, may I know is that a single check or bulk check or is the EFT payment?
[AGENT][NEUTRAL] Single, single paper check.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, great. May I have the check number?
[AGENT][NEUTRAL] 179.
[AGENT][NEUTRAL] 8640. So bear with, let me check something.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Bear with me just one second.
[CUSTOMER][POSITIVE] OK. No issues.
[AGENT][NEUTRAL] Yeah, uh,
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mm mhm.
[CUSTOMER][NEUTRAL] Yes, sir. So, uh,
[CUSTOMER][NEUTRAL] May, may I know when was the check issue?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. May I know uh if the check was cashed or not?
[AGENT][NEGATIVE] I don't have that information. I, I don't see that it's cleared.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So for this claim, we have a, I mean for this tax ID [PII]. We have submitted a 99 form to uh send it to the correct pay to address. Can you reissue this check?
[AGENT][NEUTRAL] Can you verify that tax ID number again?
[CUSTOMER][NEUTRAL] Mhm. Sure. It is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now it looks like that check went to [PII] City. Is that the correct address?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, but it is not the correct address. That's why we have sent a 99 form to reissue the check.
[AGENT][NEUTRAL] OK, hang on just a second. Let me, let me check something else for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's the name of the facility?
[CUSTOMER][NEUTRAL] It's Mercy Clinic.
[AGENT][NEUTRAL] Is it primary care or [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] I'm checking to see if we've received that, so bear with me just a second.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Mhm. No issues. Take your time.
[AGENT][NEUTRAL] We have not received that with the W9. Can you fax that to us?
[CUSTOMER][NEUTRAL] Actually, uh, yesterday when I spoke with you, one of your representatives, she has confirmed that you have received the form. Can you check, uh, she said that the name form was received in the month of Jan. I think it was on [PII] or something. I'm not sure.
[CUSTOMER][NEGATIVE] But it, it was only a month of uh Jan to the fax.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] Yeah, it looks like that was for a different claim.
[CUSTOMER][NEUTRAL] Yeah, uh, that for, for the different claim, but the tax ID is the same, right? Uh, can you update the address?
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] Give me just a second, I'm gonna check something else.
[CUSTOMER][POSITIVE] Mhm. No issues. Take your time.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] What is the correct address?
[CUSTOMER][NEUTRAL] Correct address. Yes, give me a minute.
[CUSTOMER][NEUTRAL] I will.
[CUSTOMER][NEUTRAL] I'd like to confirm that again.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Give me a minute, [PII]. I'm uh loading the correct address here to give you the correct information.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, here it is. It is [PII].
[AGENT][NEUTRAL] I'm trying to locate that in our system, so hang on.
[CUSTOMER][NEUTRAL] No, she is.
[AGENT][NEUTRAL] I just don't see that we have it in our system under our vendor address.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] here under that [PII].
[CUSTOMER][NEUTRAL] So there is no address pulling. Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm checking all the addresses that we have on file.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much. I really appreciate your efforts, surely, sir.
[AGENT][POSITIVE] Oh, it's my pleasure.
[CUSTOMER][POSITIVE] Mhm. Thank you so much.
[AGENT][NEUTRAL] And you said [PII], what is it?
[CUSTOMER][NEUTRAL] [PII]. Mhm.
[AGENT][NEUTRAL] I thought I
[AGENT][MIXED] That wasn't it. I thought I found it. I was excited, but I didn't find it.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] Yeah, um, we're gonna have to have that updated. Let me, let me check this claim as well. Hang on just a second.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let me get the document pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Sorry, sir, can I have your last name first initial?
[AGENT][NEUTRAL] Sure, it's [PII]. You want me to spell my name?
[CUSTOMER][POSITIVE] Thanks.
[CUSTOMER][NEUTRAL] Uh, um, I think I have got it, but I can spell you, you can check whether it is correct or not. Is that [PII]. Did I get it correct?
[AGENT][NEUTRAL] Well, that is a pretty name, but that's not my name.
[AGENT][POSITIVE] But I like that.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] My, you are fine. It's spelled [PII]
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] See, I, OK. [PII], OK.
[AGENT][NEUTRAL] Yeah, you're fine. Um.
[CUSTOMER][POSITIVE] I'm really sorry.
[AGENT][NEUTRAL] No, that's quite all right. So I did pull up the claim document on the HIA. It does have the billing address listed as the address that we sent that claim to the [PII].
[CUSTOMER][NEUTRAL] Uh-huh. Mhm.
[CUSTOMER][NEUTRAL] Mm mhm.
[CUSTOMER][NEUTRAL] Mm mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So if you can send in a corrected claim with the corrected billing address on the claim.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] With the W-9, they can get that check canceled and reissued.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, can you not able to, uh, make any, uh, uh, I mean,
[CUSTOMER][NEUTRAL] Make any changes because uh um since uh we have already submitted the claim, it's the past more than a year and we have already submitted the turbine form as well. If you want, I can fax the turbine form alone, but uh, sending the credit claim, it is over more than a year, right?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'll tell you, I'll tell you what we can do. If you can fax that W9 and reference the policy number and claim number and put on that fax the correct address.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Please and then put please reissue check to the correct address listed on the W9.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, can I have the fax number for the mailing of W9 form?
[AGENT][NEUTRAL] Mhm. It's 877.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Isn't uh uh the the fax number same as in the uh fax number for the claim submission?
[AGENT][NEUTRAL] It is and the reason I'm giving you that claims address is because that check would need to be reissued.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So that's why I'm giving you the claims and so if you'll just put um put on there to reprocess claim number 3,329,140 to the address listed on the W9.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, can you uh repeat the claim number again? It's 332.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] 332-9140
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, great. Thank you so much. And uh may I also have the attention which the government form has to be sent?
[AGENT][NEUTRAL] Claims, um, for this one send it to claims because it will have to be.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Reprocess, yeah, we, we do have a separate phone number for the W9s fax number, but in this instance because we need to reissue the check, it would need to come to claims.
[CUSTOMER][POSITIVE] Mhm. Reprocess. OK. Great. Thank you so much.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, fine. Thank you so much. So, and uh what I get uh in this uh claim regarding this claim, uh we have already submitted the fax, I mean 99 form through fax number. However, there is no uh form form in your end. So we have to submit the 99 form uh with the correct uh claim number and the member ID to get it reprocessed, right?
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK. Thank you so much. And yeah, thank you so much for the information. I got the information for this claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And yeah.
[AGENT][NEUTRAL] Oh, that was a tough one.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] And how many more do we have?
[CUSTOMER][NEUTRAL] I think we have a round of mhm let me check it again. Like uh 12, no, 12345678, I think.
[AGENT][POSITIVE] All right, we can do that.
[CUSTOMER][NEUTRAL] 8 more.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And I'm ready whenever you are. You're welcome.
[CUSTOMER][POSITIVE] Thank you so much for that.
[CUSTOMER][NEUTRAL] Yes. Mhm. I'm ready. It is 01845927.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Name and date of birth.
[CUSTOMER][NEUTRAL] Name [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And data service.
[CUSTOMER][NEUTRAL] Date of service, yes. It is [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEGATIVE] And bail them out
[CUSTOMER][NEUTRAL] Bill amount, $184 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And that claim, let me get that receipt date for you.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That claim we received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And processed on [PII] and denied as office visits not covered.
[CUSTOMER][NEGATIVE] Oh it's not good.
[CUSTOMER][POSITIVE] Great.
[AGENT][NEUTRAL] Getting that fax, bear with me.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh, you need the claim number.
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] Claim number is.
[AGENT][NEUTRAL] 340.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 4356.
[CUSTOMER][POSITIVE] OK, great. Thank you so much.
[AGENT][NEUTRAL] And that fax is on the way. Let me notate this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But I.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] That
[AGENT][POSITIVE] I'm ready for the next one.
[CUSTOMER][NEUTRAL] we
[CUSTOMER][NEUTRAL] Mhm. For the next one, actually, I have the claim number with me. So it's going to be.
[AGENT][NEUTRAL] Oh, OK, what's the claim number?
[CUSTOMER][NEUTRAL] Yes, the next claim number, it is 3410031.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] Name [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Let me get that receipt date for you.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] That received date, do you need the COV if you have the claim number?
[CUSTOMER][NEUTRAL] Uh, yeah, I don't have the, I'm, I'm sorry. I have the EOB. I don't have see the denial reason, so that is why I have called for this claim, so you don't have to fax the EOP for me.
[AGENT][NEUTRAL] OK, so this claim was denied as office visits not covered.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Surprise.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And may I know when was the claim was received and processed?
[AGENT][NEUTRAL] Received on [PII].
[AGENT][NEUTRAL] Process on [PII], and that's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Great. Yeah why you keep on putting the incorrect number here.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK, great. Thank you so much and uh
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I will pull up the next claim. Give me a moment.
[CUSTOMER][NEUTRAL] We have completed with [PII] now [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII], we have got the next member ID here.
[AGENT][POSITIVE] OK, I'm ready.
[CUSTOMER][NEUTRAL] Yes. It is [PII].
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] Name, yeah. Name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEGATIVE] Date of service it is [PII] and uh upon seeing the claim and I think I know the denial.
[AGENT][NEUTRAL] Well, do you have a claim number for [PII]?
[CUSTOMER][NEUTRAL] No, upon seeing the claim, the procedure code.
[AGENT][NEUTRAL] Well, I'm checking for [PII], right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I don't have a claim on file.
[CUSTOMER][NEUTRAL] Oh, what? Uh, I mean, what about the February.
[AGENT][NEGATIVE] But you probably know, you probably know what it's gonna be denied.
[AGENT][NEUTRAL] But yeah, I'm checking.
[CUSTOMER][NEUTRAL] Yes, since it is an office.
[AGENT][NEUTRAL] And the policy was active.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Let me try that.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Well, look at there. I'm sorry.
[CUSTOMER][NEUTRAL] No, no, no, no, yes.
[AGENT][POSITIVE] It does help when I put in the correct uh date of service. I apologize.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] No, no, she is. I apologize as well because confirming it the correct date of service.
[AGENT][POSITIVE] But yes, you're right. You do know that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, claim denial, uh, processed on.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let me get the 343.
[AGENT][NEUTRAL] 894
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Proceed, I mean, received on, you're fine.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] It was received on 3-19-24 and processed on 3-2024.
[AGENT][NEGATIVE] And denied, of course, you know, the denial of reason.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That is what I said. I know they did not have a reason.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yeah, most of these policies don't cover the offices. We do have some policies that do, but most don't. And this claim number is 343.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 3894.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] 3894. Great. Thank you so much.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] You need the EOB?
[CUSTOMER][POSITIVE] Yes, of course, I need it.
[AGENT][NEUTRAL] Of course. Give me one second.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][POSITIVE] I'm sorry about our uh portal. I'm hoping.
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] Later today or sometime soon that will be corrected.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No issues. Thank you so much for that. But I'll surely look into it for tomorrow. And if I'm not able to pull it tomorrow as well, I'll definitely make a call.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEGATIVE] I hope you will, you will pay.
[AGENT][NEUTRAL] Hey
[AGENT][POSITIVE] I know. I hope I get to talk to you again.
[CUSTOMER][NEUTRAL] It may be.
[AGENT][NEUTRAL] And that EOP is on the way.
[CUSTOMER][POSITIVE] OK. Thank you so much for that.
[AGENT][NEUTRAL] Am I ready for the next one?
[CUSTOMER][NEUTRAL] OK. So the next one, it is 02268420.
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] Name [PII] Well, and date of birth is [PII].
[AGENT][NEUTRAL] Data service
[CUSTOMER][NEUTRAL] Date of service? Yes, it is [PII].
[AGENT][NEUTRAL] And the bills amount.
[CUSTOMER][NEUTRAL] Bill amount, $129 even.
[AGENT][NEUTRAL] And you know
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let me get that received date and everything for you.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The receipt date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And processed on I'm sorry, [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This claim number is 353.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 314 5.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Great.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Of course it's not his offices it's not covered.
[CUSTOMER][POSITIVE] OK. Great.
[AGENT][POSITIVE] Just faxing that for you real quick.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, ready for the next one.
[CUSTOMER][POSITIVE] Yes, sure. The next one, yes. Uh, give me a minute. I think we have completed this one now.
[CUSTOMER][NEUTRAL] No, OK. No, not it. Mhm. Yes, sure. I'm ready with the next patient. It is 020.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 09122.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] Name [PII]. Date of birth is uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, data service.
[CUSTOMER][NEUTRAL] Did so [PII].
[AGENT][NEUTRAL] OK, hang on just a second. This policy turned on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Really
[AGENT][NEUTRAL] Let me give you the correct policy number for that date of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 247.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 4070.
[CUSTOMER][POSITIVE] Mhm. Great. Thank you so much.
[AGENT][NEUTRAL] Build out.
[CUSTOMER][NEUTRAL] The amount $184.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][POSITIVE] I love to hear laughter. That's a happy sound.
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, some of our colleagues has been just having some fun.
[AGENT][POSITIVE] That's good. I like to hear that.
[CUSTOMER][POSITIVE] Thank you, sir.
[AGENT][POSITIVE] Everybody needs to have fun.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. That claim was received.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] think it'll make me laugh. Um, that claim was received on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Processed on [PII].
[CUSTOMER][NEUTRAL] I'm gonna
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then I.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Is it not go. Yes.
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] Claim number is.
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] 345.
[AGENT][NEUTRAL] 0604.
[CUSTOMER][POSITIVE] 0604. OK, great. Thank you so much and you'll be, yes.
[AGENT][NEUTRAL] He is on the way.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Mhm. I'm ready.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Give me a moment at my system, it is pulling up here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] Mhm. OK. So it is here finally. So it is 019.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 076
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 07.
[AGENT][NEUTRAL] And name and date of birth.
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth, it's [PII].
[AGENT][NEUTRAL] And data service.
[CUSTOMER][NEUTRAL] Oh, that
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And build them out.
[CUSTOMER][NEUTRAL] $159 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We're gonna start singing in a minute.
[AGENT][NEUTRAL] Let's see. Claim received on 11-1824.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] In process on [PII] and deny.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Offices it never covered.
[AGENT][NEUTRAL] Claim number is 353.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 3532585.
[CUSTOMER][POSITIVE] 258 5. Great. Thank you so much.
[AGENT][NEGATIVE] And my computer is going slow now too.
[CUSTOMER][POSITIVE] OK, because we are giving so much, so much of works to them. Yes.
[AGENT][NEUTRAL] So much work. Yes, it's like slow down, stop.
[CUSTOMER][NEUTRAL] Yes, uh.
[AGENT][NEUTRAL] We're like, no, we've got a job to do.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, your apology is correct and yeah, but we are going to get it finished by the last two claims.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK. Here is our.
[AGENT][POSITIVE] And that fax is on the way, and I'm ready for the next one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Here's our second to last claim. The patient's policy number is 01792107.
[AGENT][NEUTRAL] Name and date of birth.
[CUSTOMER][NEUTRAL] Name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And data service.
[CUSTOMER][NEUTRAL] The service, yes. It is [PII].
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] And the bill amount.
[CUSTOMER][NEUTRAL] $260 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You.
[AGENT][NEGATIVE] And this claim was denied.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] As office if it's not covered.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the claim number is 3532591.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, we both have started to think.
[AGENT][POSITIVE] And I'm working on that fax for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Give me just one second.
[CUSTOMER][NEUTRAL] And what about you? Mhm, sorry to interrupt you, but, uh, what about the receipt datedden process date?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] I forgot. Sorry about that.
[CUSTOMER][POSITIVE] No issues. That's totally fine.
[AGENT][NEUTRAL] The receipt date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And processed on [PII].
[CUSTOMER][POSITIVE] Great. Thank you so much.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Claim number 35329591 and the fax number [PII]. That is on the way for you. Anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, here's the last claim. So, uh, we are gonna
[AGENT][NEUTRAL] OK, let me just take this one super quick. Hang on just a second.
[CUSTOMER][NEUTRAL] Yes, yeah.
[AGENT][POSITIVE] I'm so sorry.
[CUSTOMER][POSITIVE] Sure, no issues. You don't have to be sorry. It's OK. You can totally take your time.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK. So the next policy number, it is 02462791.
[CUSTOMER][NEUTRAL] Yeah we have a cash.
[AGENT][NEUTRAL] Do you like to sing, [PII]?
[CUSTOMER][NEUTRAL] Yes, sometimes.
[AGENT][POSITIVE] I can tell you, I bet you have a beautiful voice.
[CUSTOMER][NEUTRAL] But not
[CUSTOMER][NEGATIVE] No, absolutely not. I have such a terrible wife.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Well, it sounds like you would have a beautiful singing voice.
[CUSTOMER][NEUTRAL] Seriously.
[AGENT][POSITIVE] Because you have a beautiful voice.
[CUSTOMER][NEUTRAL] So, I can, yes, I can speak in that way, but when I speak in my
[CUSTOMER][POSITIVE] The own voice, it would get to singing voice, you will always be in tears.
[AGENT][NEUTRAL] Singing voice.
[AGENT][NEGATIVE] Oh no
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh, what is the date of er uh what's the, uh, name and date of birth first?
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK, I I think you got confused, no shit.
[CUSTOMER][NEUTRAL] Uh fine ladies, OK. So the patient's name is [PII] and date of birth, it is [PII].
[AGENT][NEUTRAL] And data service.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Date of service, yes. It is [PII].
[AGENT][NEUTRAL] And the bill amount.
[CUSTOMER][NEUTRAL] The amount. Yes, it's $184 even.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] And that claim we received on
[AGENT][NEUTRAL] 425
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, sorry, yeah.
[CUSTOMER][NEUTRAL] yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 425. I'm trying to find that received date.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 0425. Where are you?
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] There is, OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That claim we received on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And it was denied.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] As office, this is not covered.
[AGENT][POSITIVE] You're right
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that claim number is 348.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 0425.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII]. I, it's been like a great to spoke with you and I have got enough information from you. And I really, really appreciate your patience, [PII].
[AGENT][POSITIVE] That's my pleasure. Thank you. And again, I do apologize for that uh portal problem, but hopefully that will be fixed soon for you.
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] No, sir, it's totally fine. It is a technical error, right? You don't have to apologize, but it's totally fine for me, OK? And this is the best girl I have ever spoken with. Thank you so much for that.
[AGENT][POSITIVE] Oh, well, it has been my pleasure. You've been a delight to assist today and [PII], thank you for calling APL and I hope you have a very lovely afternoon.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Mhm. Thank you. Take care.
[CUSTOMER][POSITIVE] Take care. Yeah, take care. Bye-bye.
[AGENT][NEUTRAL] Mm bye bye.