AccountId: 011433970860
ContactId: b403bf9f-9449-40c5-9433-1990f9b4d645
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 546130 ms
Total Talk Time (AGENT): 198732 ms
Total Talk Time (CUSTOMER): 215588 ms
Interruptions: 2
Overall Sentiment: AGENT=2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/b403bf9f-9449-40c5-9433-1990f9b4d645_20250321T14:09_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm [PII] calling from Rader office. Uh, actually [PII], I'm looking to claim status. Could you please check?
[AGENT][POSITIVE] It would be my pleasure to assist you with that claim status, [PII]. What is the callback number?
[CUSTOMER][NEUTRAL] Yes, uh, callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh yes, uh, policy number is 023243-03.
[AGENT][NEUTRAL] And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yes, uh, patient name is [PII] and date of birth [PII].
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If you will bear with me just one moment.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm getting that pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] you.
[AGENT][NEUTRAL] I apologize.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] No, it's OK.
[AGENT][NEUTRAL] [PII], I can help you with that claim status. What is the data service?
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Uh yes, uh date of service is [PII].
[AGENT][NEUTRAL] What is the bill amount, please?
[CUSTOMER][NEUTRAL] Uh, bill amount is $493.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I'm checking on that for you. One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You know by now.
[AGENT][NEUTRAL] [PII], what is the facility name, please?
[CUSTOMER][NEUTRAL] Uh, first name is Reading Hospital Parent.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] I'm getting that received date for you, so bear with me just one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see the claim.
[AGENT][NEUTRAL] Now, we received that claim on [PII].
[AGENT][NEUTRAL] And processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim was denied.
[AGENT][NEUTRAL] As a non-covered diagnostic test.
[CUSTOMER][NEUTRAL] Non-covered diagnosis test, OK.
[AGENT][NEUTRAL] That is correct. And [PII], would you like the claim number?
[CUSTOMER][NEUTRAL] Uh yes, please.
[AGENT][NEUTRAL] That claim number is 342.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 7039.
[CUSTOMER][NEUTRAL] OK, so, uh, [PII], can you confirm, uh, can you send a directed claim or, uh.
[CUSTOMER][NEUTRAL] Uh, appeal
[AGENT][NEUTRAL] You can. The there's no time frame for a corrected claim. Appeal time frame is 180 days from the date of denial.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK. Uh, so I think this was passed. Mhm.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, so we can send uh uh collected claim, like change, like change uh the diagnosis code.
[AGENT][POSITIVE] Yes, so you can.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] OK. So, uh, OK.
[CUSTOMER][POSITIVE] Uh, thank you so much. So, uh, [PII], can you also fax the denied UOB via the fax number?
[AGENT][POSITIVE] EOPs, we actually have a provider portal, [PII], it's a lot quicker to go to that portal for that EOB and I can assist you with that if you'd like.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] If you go to [PII], that's [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] Mhm. Go in as a new user.
[CUSTOMER][NEUTRAL] Uh uh.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] That's my phone yet.
[CUSTOMER][NEUTRAL] And uh.
[AGENT][NEUTRAL] And then you're gonna choose the bottom option.
[CUSTOMER][NEUTRAL] Actually, I tried to uh
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] That's right, and that's [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK uh.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] OK. Actually, this site is not open in my uh system.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, uh, no, I will try. So, uh, if, if we, uh, open this page, so we need to go to down and there is option to, uh, download UB.
[AGENT][NEUTRAL] There is. So once you open that page, you'll choose the bottom question that you're dental or medical provider, then you're going to put in the tax ID number and the patient's account number, which is listed on box.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, 26 on the HIA that's at H103384777500 dollars and then you'll create a login and password. Once you have that account created, you'll have 24/7 access to claim status EOBs, and you can submit claims online.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Got it.
[CUSTOMER][NEUTRAL] OK, so I will uh try to uh
[CUSTOMER][NEUTRAL] After some time, uh, then I'll open this.
[AGENT][NEUTRAL] OK. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, no, thank you. So, OK, uh, yeah, so this one is open, uh, username and password, this was.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So we need to restart as a new user.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. And this was, uh, I'm a medical provider, then next, OK. Our tax ID number. So, uh can you confirm, uh uh can we uh enter, uh, how many tax ID?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So it would be one tax ID per um username and password.
[AGENT][NEUTRAL] But you can do that how many ever times you need to for different tax IDs.
[CUSTOMER][NEUTRAL] OK, OK. One tax I.
[CUSTOMER][NEUTRAL] OK. Uh
[AGENT][POSITIVE] For each provider. It's a lot quicker.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] But no. I will leave you there. OK, thank you so much, [PII], for information. And the sec[PII] also provide me call reference number.
[AGENT][POSITIVE] The reference number is my name and today's date, and I spell my name [PII], and it was a pleasure to assist you with that claim status today, [PII]. If there's nothing else I can help you with. Hope you have a wonderful day.
[CUSTOMER][NEGATIVE] Uh, no.
[CUSTOMER][POSITIVE] Uh, thank you so much.
[AGENT][POSITIVE] Thank you. Take care. Have a good weekend.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Uh, happy weekend.
[AGENT][POSITIVE] Thank you, [PII]. Take care.
[CUSTOMER][POSITIVE] Uh, yeah. Yeah, you too. Enjoy. Bye.
[AGENT][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] You too. Bye bye.
[CUSTOMER][NEUTRAL] Right.