AccountId: 011433970860
ContactId: 9b9de8f1-8f7a-4844-a8ff-b88031a32ca8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201119 ms
Total Talk Time (AGENT): 57420 ms
Total Talk Time (CUSTOMER): 64978 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/9b9de8f1-8f7a-4844-a8ff-b88031a32ca8_20250506T14:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] with NMed Health. I was calling to confirm that you had received a claim for a patient.
[AGENT][NEUTRAL] OK, I can help you with claim status, [PII]. Do you have a good callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And the policy number of that patient?
[CUSTOMER][NEUTRAL] Policy number it is 02.
[CUSTOMER][NEUTRAL] 292696
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient named [PII] or not [PII], um [PII].
[AGENT][NEUTRAL] Yeah, what is the date of service and bill charges on that?
[CUSTOMER][NEUTRAL] Data service [PII] and build charges, the total charge on the claim, it is $40,483.81.
[CUSTOMER][NEUTRAL] Um, her primary insurance took care of most of it, so it looks like the balance that we had sent to you guys was $1,121.57.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] Is it a facility claim?
[CUSTOMER][NEUTRAL] It is, yes ma'am.
[CUSTOMER][NEUTRAL] I tried to locate it on the website and it was not coming up with the patient account number that we have so I was like uh I'll just call.
[AGENT][NEUTRAL] Yeah, we've got a couple of different claims here, but I don't, it doesn't look like they're facility claims. Let me see.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that's uh
[AGENT][NEUTRAL] OK. We have a physician claim.
[AGENT][NEUTRAL] It's a physician claim.
[AGENT][NEUTRAL] Yeah, we got 3 physician claims or the 1500 forms, but I don't, I don't show UB for that date, um.
[AGENT][NEUTRAL] Let me make sure I'm not
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, so if you can resubmit, um, there's no timely filing, so resubmit with that primary explanation of benefits and we can get that processed.
[CUSTOMER][NEUTRAL] OK, and do y'all have an EDI number because I don't have one listed for you.
[AGENT][NEUTRAL] Yes, it's 60801.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, I will go ahead and get that resent out for you. Thank you.
[AGENT][POSITIVE] OK, thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You as well bye bye.