AccountId: 011433970860
ContactId: c76951e7-84f7-4fd7-81a2-a22ccee3742e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 646719 ms
Total Talk Time (AGENT): 260622 ms
Total Talk Time (CUSTOMER): 260003 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/c76951e7-84f7-4fd7-81a2-a22ccee3742e_20250522T18:40_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from East Georgia Regional Medical Center calling to check claim status on the patient.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the claim status, and the phone kind of went in and out. Did you say your name was [PII]?
[CUSTOMER][POSITIVE] [PII] Mhm. Thank you.
[AGENT][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] All right. And so [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Sure. Phone number is [PII], no extension.
[CUSTOMER][NEUTRAL] And policy number is 02469142.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] Um, data service is 1125 build out $8,449.50.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] Oh, wait a minute, it's more than one. OK, do you mind if I place you on just a brief hold?
[CUSTOMER][POSITIVE] That's fine thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Where's the very first, OK, well, we paid that one, so let's start there.
[AGENT][NEUTRAL] 3553217.
[AGENT][NEUTRAL] 356-7937.
[AGENT][NEUTRAL] 599649.
[AGENT][NEUTRAL] Is there any more? Oh no, whoa.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] 53217.
[AGENT][NEUTRAL] 01 minute.
[AGENT][NEUTRAL] Oh that's all the same claim.
[AGENT][NEUTRAL] So it's 3553217.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 355.
[AGENT][NEUTRAL] Oh my.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] All right, thank you so much for holding. I apologize for that wait. So are you wanting the original claim that was paid or the other claims that were submitted after?
[AGENT][NEUTRAL] Because we received it 3 times.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh the one that actually paid, I guess.
[AGENT][NEUTRAL] OK. Um, so the first claim we received was on [PII].
[AGENT][NEUTRAL] That claim number is 3553217.
[AGENT][NEUTRAL] And on [PII], we paid out on the claim a total of $150.
[CUSTOMER][NEUTRAL] OK, so what she said.
[CUSTOMER][NEUTRAL] Claim paid $150.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Actually, hold on one second. I'll see what happened here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So,
[AGENT][NEUTRAL] You all submitted the claim, but it came back with a, let me pull this up, hold on.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, it came back with a um discrepancy. So we were unable to accept the assignment of benefits um for the claim because the IRS reported that there was either an issue with the name and the tax ID number on, on your account.
[AGENT][NEUTRAL] So it was paid to the insured.
[AGENT][NEUTRAL] The benefit amount.
[CUSTOMER][NEUTRAL] OK, so you guys paid the patient $150.
[AGENT][NEUTRAL] Mhm. So,
[AGENT][NEUTRAL] On the IRS website?
[AGENT][POSITIVE] Um, they'll be, they'll assist you with fixing, fixing the error, and we'll just need a copy that the information has been updated so that we can start to pay y'all.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so you said that.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEGATIVE] There is a uh issue.
[CUSTOMER][NEUTRAL] With our name with the provider, with what?
[AGENT][NEUTRAL] Mhm. With the company name, it could be and or um the name and the taxpayer identification number on your account.
[CUSTOMER][NEUTRAL] Yes, uh.
[CUSTOMER][NEUTRAL] With our facility name.
[CUSTOMER][NEUTRAL] Or tax ID.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Can I spell today?
[AGENT][NEUTRAL] It's almost Friday.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Listen, and it's a holiday weekend. I'm like.
[AGENT][NEUTRAL] And it's a holiday weekend.
[CUSTOMER][NEUTRAL] What is going on? It's like my fingers like going every which way. OK. So you guys paid the patient. So the patient is respons so the claim paid $150 and the, did the patient have a responsibility also?
[AGENT][NEUTRAL] Um, so we don't determine patient responsibility because we're not the major medical, but that is the max for the benefit.
[CUSTOMER][NEUTRAL] OK. So you paid the 150 to the patient, so we could just bill the patient.
[AGENT][NEUTRAL] I can't say yes because we don't determine patient responsibility.
[AGENT][NEUTRAL] But that's how, yeah, that's how it goes.
[CUSTOMER][POSITIVE] But, OK, got you.
[CUSTOMER][POSITIVE] Yeah, got you.
[CUSTOMER][NEUTRAL] No problem. And let me ask you another question because I'm looking, I'm, I'm just, I'm working someone else's account, so I'm like lost with working this account. So, OK, so I see you guys pay 0.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I'm trying to see what else.
[CUSTOMER][NEUTRAL] Cause when the other girls like, do it, is there an EOB? I'm like, girl, I know. OK, so I'm showing, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] American Public paid 0. OK. You know what? I'm just gonna um submit this to the patient. It's gonna, I'm just gonna do it that way. No problem, my dear. Is there a reference number for our call?
[AGENT][NEUTRAL] No, so there's no call reference number, but you can use my name and today's date. Um, the first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And someone
[CUSTOMER][POSITIVE] All right. Thank you so much. Go ahead, honey.
[AGENT][NEUTRAL] You're welcome. Can I ask you a question? This is not in reference to the claim. What is your, um, like your job title?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Um, accounts receivable.
[AGENT][POSITIVE] OK. I was asking because I'm a, I just got my degree in health information management and when y'all call, I'm like, oh, I like that. So I was just asking.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do you like calling like payers and um getting the information cause all I do, I call payers, find out if the claim paid or denied, just put my note in and send it if it has to go to appeals, I send it to them or if it has to go somewhere else. Do you like doing that?
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Yeah, I had to do that for a while. I was a medical secretary. I don't know where you are. I'm in [PII]. Um, I was a medical secretary for Emory for for a while. So yeah, we had to do stuff like that, but at the time I was in school, so I didn't really, I wasn't, you know, I was just doing my job, but now I'm like, hm, let me see what these roles are called so I can start moving around a little bit.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, it's accounts receivable. Um, I do normally, when I tell people if they're looking, um, just put in billing and coding and it'll bring up a slew of stuff at medical, um, like, um, it'll do the billing part, do the coding part, accounts receivable. Do you have a profile on LinkedIn?
[AGENT][NEUTRAL] Um, I've been thinking about it, but no, I, um, I don't know.
[CUSTOMER][NEUTRAL] Do they have a free, a free one. I just told my godsister this. Um, but they have a free LinkedIn. Go on LinkedIn, make your profile, put your, um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Your resume on there?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And just let it work for you?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you can
[CUSTOMER][NEUTRAL] You can do what you wanna do with it. I mean, it goes from there. I took billing and coding. I did it, got my certification and everything, but um yeah. So I've been with this company here for 9 years, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So yeah, just let it work for you, and I mean.
[AGENT][NEUTRAL] I am so nervous to take the test.
[AGENT][MIXED] I, um, I just, I, I'm, let me not say that, let me change my wording. I, I just standardized tests make me nervous, even though it's something that I love and I love the information, it's like when I walk in the room, I just, I don't know, my hands start getting sweaty.
[CUSTOMER][NEUTRAL] Really?
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEGATIVE] I just get nervous.
[CUSTOMER][NEUTRAL] Yeah, I had a friend like that. She just got real nervous and she was like, I can't pass. I can't. But just when you go in there.
[CUSTOMER][POSITIVE] Just find something to concentrate on and just like flow through it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And yeah.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, thank you very much for um the information.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] You're welcome, honey. You are so welcome.
[AGENT][POSITIVE] Alright, well, I hope you have a great holiday weekend.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Alright, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.