AccountId: 011433970860
ContactId: 7fceab06-7abf-498e-aa25-4de8c3db2396
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1349349 ms
Total Talk Time (AGENT): 225533 ms
Total Talk Time (CUSTOMER): 265438 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/7fceab06-7abf-498e-aa25-4de8c3db2396_20250303T18:32_UTC.wav
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[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling from UC Davis. Um, I had called on the [PII] to see if someone could um assist me with why our claim is being denied saying our tax ID is not inappropriate or there's a description sheet with our tax ID number, and I was told that a claim examiner would call me back, but I've never received any return call. Can you see if there's any notes on this account for me?
[AGENT][POSITIVE] I can check that out for you. Give me your name.
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling from UC Davis.
[AGENT][NEUTRAL] [PII], what's the policy number?
[CUSTOMER][NEUTRAL] It is 02471754.
[AGENT][NEUTRAL] Your phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's the data servicing question?
[CUSTOMER][NEUTRAL] Yes, this is for um [PII] for the bill amount of $988.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, give me a moment to search and then I'll be back with you OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm still looking and seeing if it's been.
[AGENT][NEUTRAL] Maybe they adjusted it and just didn't call back. We're trying to see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is it for [PII]?
[CUSTOMER][NEUTRAL] Uh, the patient, yes, mhm.
[AGENT][NEUTRAL] And what's his date of birth?
[CUSTOMER][NEUTRAL] uh the patient's date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the initial explanation that you received was for what reason?
[CUSTOMER][NEGATIVE] It says that the claim was not processed or covered because the um description sheet for our provider tax ID number and the representative that I spoke to prior on the [PII] didn't know why or what the reason was, so she has sent a request to the claim examiner to call me back but I've never received any call back.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I am gonna take a peek at the claim. Give me a second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you for your patience.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And verify the tax identification number on this claim.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Ferring.
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII], this is [PII]. How are you?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][POSITIVE] I'm good thanks how are you?
[AGENT][NEUTRAL] Good. I had you muted. I was coughing. I'm sorry.
[AGENT][NEUTRAL] So, I'm calling regarding policy number 247.
[AGENT][NEUTRAL] 1754.
[AGENT][NEUTRAL] It's gonna be for [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then it's gonna be for claim number 3566071.
[AGENT][NEUTRAL] Can you explain the the remark code? It's saying something about the tax identification number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I have the provider holding as well.
[AGENT][NEGATIVE] She's kind of confused.
[CUSTOMER][NEUTRAL] OK, you need me to explain to the provider?
[AGENT][NEUTRAL] Yeah, I mean if this if it's a legitimate code and it's something that we're needing, I mean I can explain it. I don't even know what to tell her after reading the code.
[CUSTOMER][NEUTRAL] OK, uh, give me just a second, I'll take a look.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The note says dispatch request for B notice discrepancy letter.
[CUSTOMER][NEUTRAL] Uh yes, I'm just pulling up that letter to see what we.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Oh, OK. OK.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Oh, is it like a mailing address?
[CUSTOMER][NEUTRAL] Um, let's see.
[AGENT][NEGATIVE] Looks like that document was returned.
[AGENT][NEGATIVE] Insufficient address.
[CUSTOMER][NEUTRAL] Yeah, so they may have not even gotten the letter. I'm just taking a look here it's um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because I, I'm not sure what what the issue is. I'm just gonna to take a look.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I think I almost have it figured out. Sorry, give me just a second.
[AGENT][POSITIVE] Oh, you, you're fine. Thank you for looking.
[CUSTOMER][NEUTRAL] So far it looks like we're just gonna need them to to mail us an updated um W9 form.
[CUSTOMER][NEUTRAL] Um, so it looks like we need to verify their their mailing address.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, but let me see if there's anything else that's needed. I'm trying to see if we can open up this letter.
[CUSTOMER][NEUTRAL] Um, but essentially that's what that letter would have told them is that we needed an updated W-9.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, but just give me just one second just so I can make sure there's nothing else.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, I'm just gonna, I'm just gonna notify the examiner to upload that that, um, that letter into Onase so that we can have it for in the future, but for now just let them know just to um send us the W-9 and then once we receive it we'll be able to um complete the review of the claim.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and they can email it to us, can't they?
[AGENT][POSITIVE] Just for a quicker
[CUSTOMER][NEUTRAL] Uh, yeah, if you guys, um, pick up emails.
[AGENT][NEUTRAL] Yeah, yeah, it's just W9. OK, all right, so what is it lacking that it didn't have?
[CUSTOMER][NEUTRAL] We just need to verify the mailing address.
[AGENT][NEUTRAL] OK. All right. I'll let her know.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Uh-huh, thank you.
[CUSTOMER][NEUTRAL] Mhm bye bye.
[AGENT][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] OK, [PII], thank you so much for holding. So I've learned that they are requesting they send a letter out to the address uh that's on the file. It may have been returned. They're needing an updated W9 form with the mailing address.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can email that.
[CUSTOMER][NEUTRAL] And where could I.
[AGENT][NEUTRAL] I'll give you an email address.
[CUSTOMER][NEUTRAL] OK, what's the
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] It's, it's [PII]
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] altogether, so that's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And, um.
[AGENT][NEUTRAL] Attach a copy of the W9. You can just put W9 in the subject line.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then do I need the patient's name or claim number or anything like that for them to identify that this.
[AGENT][NEUTRAL] You may
[AGENT][NEUTRAL] Mhm. You may want to reference the policy number and the claim number.
[CUSTOMER][NEUTRAL] Policy number and the claim number. OK. All right, so that was Kit. Mhm.
[AGENT][NEUTRAL] And what, what
[AGENT][NEUTRAL] Go ahead, go ahead.
[CUSTOMER][NEUTRAL] Uh, the email, let me just confirm, was uh [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and, uh, what was your other information that you was gonna provide to me?
[AGENT][NEUTRAL] Um, I was wanting you to verify the claim number. Do you have a claim number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, yes, I do. Give me one second here and I will go ahead and um provide that claim number to you.
[CUSTOMER][NEUTRAL] Uh, his claim number that I have on file is 3561125. Is that correct?
[AGENT][NEUTRAL] The claim number.
[CUSTOMER][NEUTRAL] Yes, the claim number that we uh received the you before was 3561128.
[CUSTOMER][NEUTRAL] Is that the correct claim number or is there a different claim number?
[AGENT][NEUTRAL] Let me pull up that number. I don't show that under [PII], that number.
[CUSTOMER][NEUTRAL] OK, that's the claim number, but the policy number is different.
[AGENT][NEUTRAL] So you gave me 247-1754, so the policy number is the same 3566. Give me a second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 28. OK, so actually, um.
[AGENT][NEUTRAL] We're having this issue with three of the dates of service that you sent, so this one is for [PII], uh, total charge.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] This is for the ER physician's visit, the one that you gave me.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Yes, uh, for the 988. And then I do see another claim for $52.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then another one for 114. So, um, should I go ahead and send it for for all three of them? So do you have the claim number for each, each claim?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If you can
[AGENT][NEUTRAL] Yes, that's what I was wanting to give you. So in addition to the one that you already have that which is the 3561128 also include claim number 3566.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 060.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then 356-607-1.
[CUSTOMER][NEUTRAL] OK. All right, thank you. And then um do you provide reference call number for our call today?
[AGENT][NEUTRAL] Uh, not necessarily a reference number, but you can use my name in today's date, uh, to refer to the call if you should happen to call us back.
[CUSTOMER][NEUTRAL] OK, and
[CUSTOMER][POSITIVE] OK alright thank you so much for your help I appreciate it and I will get this over to you guys.
[AGENT][NEUTRAL] OK, do you know if you'll be sending the W-9 today?
[CUSTOMER][NEUTRAL] Yes, I am getting ready to upload it and send it to the care team that uh you provide me the um ref the email to right now.
[AGENT][NEUTRAL] OK, email address. OK, very good, [PII], anything else?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK thank you uh no that was it thank you so much I appreciate your help.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.