AccountId: 011433970860
ContactId: 91eee0cd-fcf0-42c6-be63-f25e1ad5d931
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 379089 ms
Total Talk Time (AGENT): 152481 ms
Total Talk Time (CUSTOMER): 104199 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/91eee0cd-fcf0-42c6-be63-f25e1ad5d931_20250210T14:03_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, my name is [PII] calling from provider office to check on the claim status.
[AGENT][POSITIVE] Well [PII], it would be my pleasure to assist you with claim status today. What is a good callback number?
[CUSTOMER][NEUTRAL] And my callback number is
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] The policy.
[CUSTOMER][NEUTRAL] Uh, policy ID is 019.
[CUSTOMER][NEUTRAL] 862-669.
[AGENT][NEUTRAL] And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] The patient name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And I understand you're needing claim status, correct?
[CUSTOMER][NEUTRAL] Yes. Could you spell out your name for me?
[AGENT][NEUTRAL] All right, I
[AGENT][NEUTRAL] Sure. My name is [PII].
[AGENT][POSITIVE] And it would be my pleasure to help you with that claim status to you. What is the data service?
[CUSTOMER][NEUTRAL] Is the service is [PII].
[AGENT][NEUTRAL] And that bill amount.
[CUSTOMER][NEUTRAL] And the bill amount is $2000 even.
[AGENT][NEUTRAL] And what is the facility name please ma'am?
[CUSTOMER][NEUTRAL] Yes. Um, the facility name is Hillcrest Medical Center.
[AGENT][NEUTRAL] I'm checking, bear with me just one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's for a facility claim?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] That is for a facility claim?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And that's billed on a UBO4.
[AGENT][NEUTRAL] From the facility.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] The reason I'm asking because I have a claim for $2000 for that data service but not from the provider.
[AGENT][NEUTRAL] Uh, facility information.
[AGENT][NEUTRAL] You said it's Hillcrest Medical Center?
[CUSTOMER][NEUTRAL] This facility name Crest Medical Center.
[AGENT][NEUTRAL] What's the billing name?
[CUSTOMER][NEUTRAL] And the building name is Emergence Health PLLC.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, [PII]. I did find that clean.
[AGENT][NEUTRAL] We actually received, we do have that claim on file.
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We received the claim.
[AGENT][NEUTRAL] On 6-17-2024.
[AGENT][NEUTRAL] And it is pending for the primary EOB. We are secondary.
[AGENT][NEUTRAL] So we need the primary EOB from Blue Cross Blue Shield of Oklahoma.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And Gia, if you have
[CUSTOMER][NEUTRAL] When does your insurance?
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Yes. When does the insurance become secondary? Can I know the date?
[AGENT][NEUTRAL] On [PII].
[AGENT][NEUTRAL] For this patient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I have the uh primary insurance policy ID?
[AGENT][NEUTRAL] You would need to contact the the patient for that. We don't have the policy ID.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I have the um effective date?
[AGENT][NEUTRAL] Effective date on the plan is [PII].
[CUSTOMER][NEUTRAL] Termination.
[AGENT][NEUTRAL] And the [PII].
[CUSTOMER][NEUTRAL] Termination on [PII], right?
[AGENT][POSITIVE] Yes, ma'am, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the uh claim mailing address for this claim?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII] City.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And the zip code is [PII], and that can also be faxed directly to our claims department.
[CUSTOMER][NEUTRAL] OK. And
[CUSTOMER][NEUTRAL] May I know the timely filing limit to resubmit the claim?
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] OK, may I know the fax number?
[AGENT][NEUTRAL] Fax number to our claims department is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, [PII]. Uh thank you for your kind assistance. That's it for you today. Have a great day. Bye.
[AGENT][POSITIVE] [PII], thank you for calling APL. It was a pleasure to assist you with that claim status, and I hope you have a wonderful day as well. Take care.
[CUSTOMER][POSITIVE] Yes, stay safe. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.