AccountId: 011433970860
ContactId: 81eb35a5-cadc-4690-a054-4484c949a9ae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 342850 ms
Total Talk Time (AGENT): 96850 ms
Total Talk Time (CUSTOMER): 239531 ms
Interruptions: 5
Overall Sentiment: AGENT=1.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/81eb35a5-cadc-4690-a054-4484c949a9ae_20250217T16:33_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I'm calling, I'm calling from Emory University Hospital. I'm calling to check on claim status, please.
[AGENT][POSITIVE] It would be my pleasure to assist you, [PII]. What is the callback number?
[CUSTOMER][NEUTRAL] It's [PII]. I'm [PII].
[AGENT][NEUTRAL] Thank you, [PII], and what is the policy number for the patient?
[CUSTOMER][NEUTRAL] It is let's see here scroll down 60801.
[AGENT][NEUTRAL] That's gonna be our payer ID.
[CUSTOMER][NEUTRAL] Oh let me see if they copied the card. I'm gonna say that is so that's a little. Let me see. Not a lot of numbers on there. I meant to, but gosh, can't even talk this morning. Let's see here. I hope they.
[AGENT][POSITIVE] Sorry, this Monday for sure.
[CUSTOMER][NEUTRAL] Hey, I'm not making excuses.
[AGENT][NEUTRAL] Hey.
[CUSTOMER][NEUTRAL] OK, so that's Cross they have primary Blue Cross and then.
[CUSTOMER][NEUTRAL] Please let this be it. Oh, OK. Oh, group OK, uh, I payer IDs group number where's.
[AGENT][NEUTRAL] Inpatient or outpatient benefits or numbers bottom.
[CUSTOMER][NEUTRAL] In hospital. Uh, OK, so, OK, so.
[CUSTOMER][NEUTRAL] Because this what you have done, hold on, um, what they have done. I wanna make sure I'm getting the right ID number. Did they just, oh, it's just one charge.
[AGENT][NEUTRAL] Either one is fine. It's the same number. Yes, so.
[CUSTOMER][NEUTRAL] Let's see EKG, so it's the outpatient. So let me go back. I wonder, gosh, did they submit it 3 times while we, um, come on, let me, our system is so slow today. It's just like going like a snail. OK, so I pay I pay uh 0234 0 they're the same. OK, so 02344316 ML 8. So if it was an inpatient.
[CUSTOMER][NEGATIVE] Our inpatient hospital will end with the 7, so this is ML 8 at the end. Let me write this down. Why did they submit it with they submit it with the payer? Gosh, no wonder why they're not getting it or we don't have unless you have it for some reason and.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And we need
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Well, what's that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII], if I'm pronounce that correctly, uh, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, and we're needing claim status correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, I can help you with that and [PII], what is the date of service?
[CUSTOMER][NEUTRAL] Let's see because there's only one line on it and it says [PII] for $235.
[AGENT][NEUTRAL] And what is the facility name?
[CUSTOMER][NEUTRAL] Emory University Hospital.
[AGENT][NEUTRAL] OK, I don't have the facility claim for that data service.
[CUSTOMER][NEUTRAL] It's probably because of ID.
[AGENT][NEUTRAL] It might be.
[CUSTOMER][NEUTRAL] That's uh they could let me see, did they update this it looks like on here twice. Let me see here, um, I just have to add it, um.
[AGENT][NEUTRAL] Now you
[CUSTOMER][NEUTRAL] Oh they OK, they did it so I know I what I have to do. OK, I have to add this in because they put this as coverage not effective, and it has, wait, why does, oh it's the ID number.
[CUSTOMER][NEUTRAL] 023, but and I actually wait, did they resubmit the claim with the correct ID? Let me double check because I'm here 3 times. OK, the first time went [PII].
[CUSTOMER][NEUTRAL] Nope, that's the that's the payer number. Then again it went on [PII] with the payer ID and then oh finally on [PII] they submitted with the 023, but at the end it does it has MLB and it doesn't or ML 8.
[CUSTOMER][NEUTRAL] We definitely know wait um OK that OK they just submitted correctly on [PII] with the correct ID number that 023 number.
[AGENT][NEUTRAL] Yeah, do you know how they submitted it, whether it was by mail or?
[CUSTOMER][NEUTRAL] It goes electronically, yeah, it goes electronically, and the address that we have is [PII].
[AGENT][NEGATIVE] That is not the correct uh address for this product.
[CUSTOMER][NEUTRAL] OK, let me go back and see if they updated because I see they updated.
[AGENT][NEUTRAL] And you can fax it directly to us with the primary it is [PII].
[CUSTOMER][NEUTRAL] The new 10, is it the Oklahoma?
[CUSTOMER][NEUTRAL] Is it the Oklahoma, OK, [PII]. OK. I'm, yeah, they updated but they did not add this on. OK, so the wrong address. So what I'll do, I'll go ahead and update that and we'll get that resubmitted then. And can I have your call, uh, your name again? Sorry, jeez.
[AGENT][POSITIVE] And not a problem and you can fax that directly to us with the primary EOB as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If you're interested in the fax number.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] Fax number is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942-3 come straight to our claims department.
[CUSTOMER][NEUTRAL] Oh, I have your name [PII] I'm sorry. OK, yeah [PII], can I have your call reference number please?
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Sure, reference number is my name and today's date, and the first initial of my last name is [PII], it was a pleasure.
[CUSTOMER][POSITIVE] The minus C as in cat. It was nice talking to you. Thank you so much. Have a great day.
[AGENT][POSITIVE] Thank you, [PII]. Nice talking to you and assisting you with the claim status. Hope you have a great day as well and thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] You do both.