AccountId: 011433970860
ContactId: 955c7c71-dd19-493e-8989-58f4ef5919d8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250649 ms
Total Talk Time (AGENT): 84838 ms
Total Talk Time (CUSTOMER): 114717 ms
Interruptions: 1
Overall Sentiment: AGENT=-0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/955c7c71-dd19-493e-8989-58f4ef5919d8_20250331T12:19_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Um, I'm calling from Digestive Disease Associates. I was just calling to follow up on a claim that was sent to you guys quite a while ago.
[AGENT][NEUTRAL] OK, I
[AGENT][NEUTRAL] I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Let me see, 01982180 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um [PII].
[AGENT][POSITIVE] Thank you for that information, [PII] and we're checking claim status.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, it's [PII], date of birth is [PII].
[AGENT][NEUTRAL] OK, and what's the date of service and total charge?
[CUSTOMER][NEUTRAL] Um, looks like data service [PII]. bill amount was $1450. It looks like.
[CUSTOMER][NEUTRAL] All that would have been sent to you guys was $492.05 because it looks like uh Aetna paid prior.
[AGENT][NEUTRAL] Is this a professional fee or facility?
[CUSTOMER][NEUTRAL] Um, facility, I believe.
[AGENT][NEUTRAL] Yeah, I don't show a facility claim for that data service.
[AGENT][NEUTRAL] For [PII], I mean [PII].
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Mhm I don't show a facility charge. What's the name of the facility?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] North Florida Regional Medical Center.
[AGENT][NEUTRAL] Right. I see charges related to that surgery but not the facility charge.
[CUSTOMER][NEUTRAL] OK. Is there professional charges?
[AGENT][NEGATIVE] We've received other claims by other providers.
[CUSTOMER][NEUTRAL] OK, OK. Um, was it received by digestive disease associates?
[AGENT][NEUTRAL] OK, so you're calling for the hospital charge, right?
[CUSTOMER][NEUTRAL] I, I'm all of it, so I work in the facility. I work in the like private practice digestive disease associates and North Florida Endoscopy Center, as well as the claims for North Florida Regional Medical Center.
[AGENT][NEUTRAL] OK, so did you file any other claims to APL?
[CUSTOMER][NEGATIVE] Uh, I'm not, not that I can see for that date of service. There's just this one that's not paid.
[AGENT][NEGATIVE] OK, because I don't show any for you. Yeah, I don't show any.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you file a diagnostic charge or no?
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Like diagnosis codes on the claim.
[AGENT][NEUTRAL] No, you said that you do you bill for the the professional and facility or just for the facility?
[CUSTOMER][NEUTRAL] I believe it's just for the facility.
[AGENT][NEUTRAL] OK, so I don't show the facility charge on file.
[CUSTOMER][NEUTRAL] see
[CUSTOMER][NEUTRAL] OK, so there's no claim on file. What is your timely filing?
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] OK, and then, um,
[CUSTOMER][NEUTRAL] What's your payer ID?
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][NEUTRAL] And then the billing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 950.
[AGENT][NEUTRAL] Oklahoma City, Oklahoma.
[AGENT][NEUTRAL] And the zip code is [PII]?
[CUSTOMER][NEUTRAL] OK, perfect. And then can I just have a reference number please?
[AGENT][NEUTRAL] My name in today's date.
[CUSTOMER][NEUTRAL] And what was your name again? I'm sorry.
[AGENT][NEUTRAL] [PII] name [PII] and anything else, [PII]?
[CUSTOMER][POSITIVE] No, that was it. Thank you.
[AGENT][POSITIVE] You're welcome thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] You too.