AccountId: 011433970860
ContactId: 7f02588f-9f75-4685-90e9-5c286781066a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 582700 ms
Total Talk Time (AGENT): 176563 ms
Total Talk Time (CUSTOMER): 376687 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/7f02588f-9f75-4685-90e9-5c286781066a_20250403T20:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], I'm [PII]. Um,
[CUSTOMER][NEUTRAL] I've been going back and forth with um.
[CUSTOMER][NEGATIVE] Well, you guys have denied my claim. Uh, I, I, I sent the UB over to you guys and the itemized bill but it didn't have my admission time and discharge time.
[CUSTOMER][NEUTRAL] And so I've been fighting with the hospital like tooth and nails to get that. And I had to go through their medical records department and they sent me two discs, which I found that you guys can't read the disc because you guys work from home, which I do as well because I'm mean, I pay healthcare claims all day. But anyways, finally, I had a day off last week and I was able
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] To go to the hospital and pick up some information. Um, and I wanna make sure that I still fax it to the same number. I also wanna make sure this doesn't get denied for timely because I've been messing with this for, I mean, my accident was a year ago.
[AGENT][NEUTRAL] OK, that's fine, um, Ms. [PII], uh, I can help you with your claim and there isn't a timely filing limit with our company, so don't worry about that, um.
[CUSTOMER][NEUTRAL] 00 God.
[AGENT][NEUTRAL] Yes, ma'am. Can I please get your policy number?
[CUSTOMER][NEUTRAL] Yes ma'am. It is 02.
[CUSTOMER][NEUTRAL] 435-427
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] I think that's right. I don't have heater on.
[AGENT][NEUTRAL] OK, I do see you. And can you please verify your policy for me? Can you give me your date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] It's [PII] and my phone number is [PII] and the email is [PII].
[AGENT][POSITIVE] Thank you very much and if we get disconnected Ms. [PII], is this a good number to call you back on?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, thank you and do you happen to have a claim number?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEGATIVE] I have a reference number on this. I've got so much crap right now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But you have no idea. I mean, I'm calling you on my um break, um, yeah, because I guess it'd be the reference number is what you guys have because it says in order to process your claims we need to itemize uh blah blah blah, um, with the admission discharge dates and times and the UB I don't know why the hell [PII] didn't put that on the UB um or the itemized bill. That's why I had to go through medical records, but.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, the reference number it looks like 02.
[CUSTOMER][NEUTRAL] 435-427
[AGENT][NEUTRAL] OK, yes, that's your policy number, um.
[CUSTOMER][NEUTRAL] Oh, that's the reference number too.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Because I do see.
[CUSTOMER][NEUTRAL] Well, I don't know.
[AGENT][NEUTRAL] I do see a claim.
[CUSTOMER][NEUTRAL] It was from my
[CUSTOMER][NEUTRAL] Yeah, it was for like they billed for like my UV that I because I faxed this all to you guys a long time ago with the item bill um it was for [PII].
[AGENT][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK. I'm looking at, um, I'm looking right now at your policy.
[CUSTOMER][NEUTRAL] Yeah, I mean
[AGENT][NEUTRAL] And I do see that.
[AGENT][NEUTRAL] On and you may already know about this, that, uh, a check was sent out. The check number is 2.
[CUSTOMER][NEGATIVE] That was, that was, that was, that was only for $100 and that was not, that was not for the facility.
[AGENT][NEUTRAL] Right, right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, this is for the facility charges. The UB that I sent to you guys was like uh $56,999.27 and I know you've got it because I've spoken to.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You wouldn't believe I've called you guys and it's from the hos it's, it's from the hospital Saint Luke's East.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, and you, you really just needed to make sure that you had the correct fax number to send all this information in that you've gotten this time is that.
[CUSTOMER][NEUTRAL] Yeah, do you, do you, do you need me to read fax the whole UB an itemized bill along with what I have?
[AGENT][NEUTRAL] No, ma'am. You just need.
[CUSTOMER][NEUTRAL] Or can I just, I.
[AGENT][NEUTRAL] Just refer back, yeah, just fax the information that they're requesting.
[CUSTOMER][NEUTRAL] The statues.
[CUSTOMER][NEUTRAL] OK, and but I don't have, I, I don't see a claim number on this so.
[CUSTOMER][NEUTRAL] Like I said, the information I got from you does not have a claim number. It just has my policy number and then the reference numbers.
[CUSTOMER][NEUTRAL] Kind of weird
[AGENT][NEUTRAL] OK, let me look real quick.
[CUSTOMER][NEUTRAL] They got Saint Lou
[CUSTOMER][NEUTRAL] Um, so yeah, if you have a claim number for me to reference, that would probably be good.
[AGENT][NEUTRAL] OK, alright, let me, let me pull it up.
[AGENT][POSITIVE] Real quick again. Uh no, it's not a problem.
[CUSTOMER][NEUTRAL] All right, I
[CUSTOMER][NEUTRAL] Like I said, I'm doing this, doing this on my lunch, so.
[AGENT][NEUTRAL] Yes ma'am, I understand.
[CUSTOMER][NEGATIVE] Yeah, I'm like I've paid all these premiums to you guys and then it's like, oh I can't get anything processed other than I did get the $100 check, which was nice, but this is for the large hospital, this is large hospital bill and then you guys will reimburse me, correct?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right, since you're the one that's filing the claim now it's not being sent by them.
[CUSTOMER][NEGATIVE] OK, good, because yeah, they're, that's a whole another story. I've already, they turned me over to collections, even though I've called them like, oh yeah, it's ridiculous. So I had to pay them some money to get them off my butt.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I feel sorry for people that don't understand healthcare. I've been in billing and insurance since the [PII], so luckily, I understand that it's, it's just such a rat race.
[AGENT][NEUTRAL] OK. Yes, I feel bad for you. You have to go through all that. OK, I've got the claim number that you're going to refer to.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 355-038-0.
[CUSTOMER][NEUTRAL] OK, claim number is 355-0380.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And that's for the facility.
[CUSTOMER][NEUTRAL] Alright, so that's for that's for my facility, OK. And then the number that I originally faxed the UB an itemized bill was to claim support at [PII]. Is that still correct?
[AGENT][NEUTRAL] Uh, let me look and see. Yes, that is correct.
[CUSTOMER][NEUTRAL] Alright, I'll just put claim support again correct?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, I'm gonna do that, um, this weekend, um, I'll get that faxed because I have to go to UPS because I don't have a fax at home, so I'll, I'll get that. Uh, can you note my account that I'm gonna be faxing, um, the admission time and dates.
[AGENT][NEUTRAL] Um, I will put that in the notes, um, and like I said, don't worry because there's not a timely filing limit.
[CUSTOMER][NEUTRAL] OK, yeah, what they gave me, uh, I mean, do you want me to circle so you guys can find it easy or?
[AGENT][POSITIVE] You can do that, yeah, that would be helpful.
[CUSTOMER][NEGATIVE] I already had to pay them, um, I had to pay them for the two disks that they sent me. They never told me they send it, we're sending it on a disk, but yeah, what I'll send you, I'll just circle the um.
[CUSTOMER][NEGATIVE] My dates and time. I, I just, I don't understand. I, as long as I've been in billing and insurance, we, I don't know why [PII]'s didn't put that on their UB or itemized bill. It's kind of ridiculous.
[AGENT][POSITIVE] Yeah, you would think that they would put that to help their customers, you know.
[CUSTOMER][NEUTRAL] You would think, but anyways, uh, yeah, luckily I had the day off last Friday. Um, so I had to go, not even the hospital I was at, I had to go to the main hospital, which isn't even close to my
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Just to get the information and I was there for like 3 hours.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] L
[CUSTOMER][NEGATIVE] That's ridiculous.
[AGENT][NEUTRAL] Yeah, that's that's a lot to go through.
[CUSTOMER][POSITIVE] But all right.
[CUSTOMER][NEUTRAL] Yeah, well, I'll get the sex Saturday since Saturday is my day off.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] All right, and I've got it noted on your policy, OK?
[CUSTOMER][POSITIVE] Alright, thank you so much.
[AGENT][POSITIVE] You're welcome. You have a great day and thank you for calling APL.
[CUSTOMER][POSITIVE] All right, thank you, bye.
[AGENT][NEUTRAL] Mm bye-bye.