AccountId: 011433970860
ContactId: c0954ed2-ba8e-4ae8-893c-209d7512ebb9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 809750 ms
Total Talk Time (AGENT): 302819 ms
Total Talk Time (CUSTOMER): 194423 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/c0954ed2-ba8e-4ae8-893c-209d7512ebb9_20250325T12:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Morning [PII].
[AGENT][POSITIVE] Good morning.
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling from WVU Medicine. I have a couple denials I need to talk to you about. Looks like you need something from me.
[AGENT][NEUTRAL] Hi
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. All right, [PII]. So you have a couple of claims, so that's the same patient?
[CUSTOMER][NEUTRAL] They are, yes, I say denial, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and you said they're both right and you'll need additional information on that, is that correct?
[CUSTOMER][NEUTRAL] Yeah, he has a total of 4, and they all say that there's a discrepancy and.
[CUSTOMER][NEUTRAL] Uh, how was it worded?
[CUSTOMER][NEUTRAL] Uh, denied claim due to the combination of the name and tax ID number in your account is incorrect.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, [PII], yes ma'am, I can help you with this. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] 02553145
[AGENT][NEUTRAL] OK, thank you. So give me a moment to get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK, so first off, [PII], any information that I do provide today would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the date of the first.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Data service in total bill amount?
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][NEUTRAL] 1114 [PII] $400.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] Alright, so give me just a couple of moments and just to look at a few things please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so what, uh let's go ahead and get
[AGENT][NEUTRAL] The other dates of service, um, and total bill I need to do, [PII] on this is to get all of your direct contact information including your email and I will send an email to the person that you would need to speak to and they will give you a call back about this.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So what is
[CUSTOMER][NEUTRAL] Um, so
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] He has 3 more and they're all on the date of service [PII].
[AGENT][NEUTRAL] 11:13. OK. And what is the um first bill amount?
[CUSTOMER][NEUTRAL] $746.
[AGENT][NEUTRAL] OK, so let me give me just a moment to locate.
[AGENT][NEUTRAL] H1.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And do you have, did you receive um the claim numbers on these or just the letter regarding.
[AGENT][NEGATIVE] The denial.
[CUSTOMER][NEUTRAL] Um, no, they came up they, they have none.
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So they they didn't have one on the letter um I mean I did pull a letter up I didn't physically get the letter of course um we have it scanned into a system and I found it in there so I did get that information off of it but it was uh just a basic standard letter saying that the um, what I read to you was that the uh.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] Tax ID and the um name of the provider is incorrect combo.
[AGENT][NEUTRAL] OK. OK. All right. And then also on [PII], what was the next bill amount?
[CUSTOMER][NEUTRAL] Uh, he has 2 that day for the same amount of $380.
[AGENT][NEUTRAL] Two of them, two separate claims for 380.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Do you need the individual provider's name?
[AGENT][NEUTRAL] I, no, ma'am, I don't. Not, not yet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, give me just a moment to look at.
[AGENT][NEUTRAL] A few more things on here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you for your patience.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] That's the only way you can do this job.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so let's see, that's, is that, I'm so sorry. Did you say there were, there was one more charge for the 11:13 data service or only the 3, the 746 and then the 380 twice.
[CUSTOMER][NEUTRAL] That's correct, yes, there was a total of 4.
[AGENT][NEUTRAL] That's correct. All right, [PII], what is your last name?
[CUSTOMER][NEUTRAL] That is correct. Well, I mean that's all that's in my work here right now, so it's hard to tell if there's any more out there. Um, my name is, it, it's got, you would need my email address also. So it's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I am, yes, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I'm gonna read this back. [PII].
[CUSTOMER][POSITIVE] That is correct, yes.
[AGENT][NEUTRAL] OK, and then your direct line is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] It is.
[AGENT][NEUTRAL] OK, and there's not an extension or an option that would need to be selected? OK, um, let's see.
[CUSTOMER][NEUTRAL] Nope.
[AGENT][NEUTRAL] I wanna make sure I'm just getting all that I have all.
[AGENT][NEUTRAL] All the information that I'm gonna need to
[AGENT][NEUTRAL] Email um
[AGENT][NEUTRAL] OK, and what is the name of the
[AGENT][NEUTRAL] The uh provider group.
[AGENT][NEUTRAL] That you're calling on behalf of is.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's WVU Madison, um.
[AGENT][NEUTRAL] WV medicine, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so yes ma'am. So and you and you do have a copy of the letter that was sent stating that we weren't able to accept assignment of benefits for the claim due to a discrepancy.
[AGENT][NEUTRAL] Reported to us by the IRS that is a combination OK of the name and taxpayer identity.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] ation number
[AGENT][NEUTRAL] That's what you have a copy of, is that correct?
[CUSTOMER][POSITIVE] That is correct, yes.
[AGENT][NEUTRAL] OK. All right, so, um,
[CUSTOMER][NEUTRAL] So I just didn't know if you needed the W-9 or they'll let me know what you need exactly.
[AGENT][NEUTRAL] This according to the information that I have, it states to visit the IRS website for additional information on how to resolve this issue and stop back up withholding once this is resolved with the IRS. Please send APL a copy of the updated information.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] So again I'm going to send your information to the contact here that handles this type of thing and they will.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Be in contact with you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] How long, how long should I expect? I'll just note it in the first so I don't have it in my work queue waiting for it.
[AGENT][NEUTRAL] [PII], I would, um, I would give it probably a couple of days, to be honest.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it could
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEGATIVE] be today, but I don't want to overpromise. I don't wanna overdeliver for you.
[CUSTOMER][POSITIVE] Oh no, no, I never get anything resolved that quickly, so I won't be disappointed and I'm sorry, what was your name again? Is there a reference number?
[AGENT][NEUTRAL] Again, my, yes, you're actually gonna use my name, [PII] and today's date again my.
[AGENT][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] And if your first initial to my last name it's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I appreciate all your assistance. Thank you so much. You have a wonderful day.
[AGENT][POSITIVE] OK. Well you are, yeah, I hope you do too, [PII]. Is there anything else I can help you with this morning?
[CUSTOMER][NEUTRAL] No, that was all that I have so far for you. We'll see what, what, what else comes in the work before the day is over.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] Uh, I understand that as well. So again, if that's all at the moment, thank you for calling APL. And if I should not talk to you again today, [PII], I hope you have a great day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.