AccountId: 011433970860
ContactId: 946c2710-9428-4f78-b239-2b91b9af8d36
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 526840 ms
Total Talk Time (AGENT): 150747 ms
Total Talk Time (CUSTOMER): 163035 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/946c2710-9428-4f78-b239-2b91b9af8d36_20250307T22:12_UTC.wav
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[CUSTOMER][NEUTRAL] I'm on the phone.
[AGENT][POSITIVE] Thank you for calling APL this is [PII] how may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Hogue Memorial Hospital, and I'm calling to verify if a claim was received.
[AGENT][NEUTRAL] OK, I can help you with the claim. Um, [PII], can I please get your call back number just in case the call gets disconnected?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Sure. It's um [PII].
[AGENT][NEUTRAL] Thank you. And then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Uh, yes, so let's see here. Date of birth is [PII]. Policy number is 01988261.
[AGENT][NEUTRAL] OK, and the member's name, please?
[CUSTOMER][NEUTRAL] That's for [PII].
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK and then can you please give me the data service and the charge amount?
[CUSTOMER][NEUTRAL] Yes, so it's for uh [PII], and the total bill charges on this amount on this account are $3,808.27.
[CUSTOMER][NEUTRAL] It looks like the claim was submitted several times.
[CUSTOMER][NEUTRAL] Um, the last one.
[AGENT][NEUTRAL] OK, can you give me the charge amount?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yes, that's $3,808.27.
[AGENT][NEUTRAL] OK, and then the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] OK, that would be 1 2nd here.
[CUSTOMER][NEUTRAL] The primary paid 1775.38.
[CUSTOMER][NEUTRAL] Let's see, one second. The remaining is 19, I'm sorry, 1,946.62.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. I'm gonna put you on a brief hold, um, Ms. [PII], so I can pull in this claim for us and I will be right back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright thank you.
[AGENT][POSITIVE] Thank you
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 1494.
[AGENT][NEUTRAL] Hm, that ain't it.
[AGENT][NEUTRAL] 3125.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Hi there, Ms. [PII].
[AGENT][NEUTRAL] Is the name of the facility Hogue Memorial Hospital, or is the name of the facility something different?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Hogue Memorial Hospital.
[AGENT][NEUTRAL] OK, we're not, I'm not finding the claim under Hogue Memorial Hospital.
[CUSTOMER][NEUTRAL] Mm hm.
[CUSTOMER][NEUTRAL] Yeah, that's uh the ID number the tax ID.
[AGENT][NEUTRAL] I see that there's been several claims that are.
[AGENT][NEUTRAL] Duplicates, but they're not for that facility name. That's why I asked you if it could have been a different name. Oh wait.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Hogue Presbyterian.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Would that be
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you spell Hoag H O A G?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, and let me keep, I keep looking at some of these duplicates to see because you had mentioned it would have been no.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yeah, I'm not finding Hogue Memorial Hospital. I'm gonna look at some claims around that area that that data service to see if any of those might be it.
[CUSTOMER][NEUTRAL] Yeah, and then it looks like it was faxed on [PII], but we haven't received any, um, EOB, so that's why I was like I wonder if it's been received because yeah, they're um it kept it uh we we would call it um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] From the last notes I see that it was also no claim on file so then the rep had advised to fax over to [PII], which we did so I'm not sure why it's not being.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Received
[AGENT][NEUTRAL] I do find um now I looked on the date around the date that you said it was faxed in. I do find a Hogue Memorial Hospital for data service of.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] And it's a completely different amount.
[CUSTOMER][NEUTRAL] Right, yeah, I know that's not, that's not the one that could probably.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] What fax number are you guys using?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, so the one that.
[AGENT][NEUTRAL] Let's verify that real quick.
[CUSTOMER][NEUTRAL] Let's see, that was the number given at was [PII].
[AGENT][NEUTRAL] Yes, that's correct. Do you guys have the um payer ID number to send it electronically?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, what's the payer ID number? Maybe I can verify that too. We can send it out as well.
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I'm gonna go ahead and try that. um, may I have a, a reference number um for our call today, if any?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All right, thank you so much for your help.
[AGENT][POSITIVE] You're welcome, Ms. [PII]. I hope you have a great weekend and I appreciate you calling APL today.
[CUSTOMER][POSITIVE] Thank you, you too.
[AGENT][POSITIVE] You're welcome. Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Bye bye.