AccountId: 011433970860
ContactId: c7c58f29-50a6-4377-afde-f9ea05103307
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 632590 ms
Total Talk Time (AGENT): 194834 ms
Total Talk Time (CUSTOMER): 332080 ms
Interruptions: 5
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/c7c58f29-50a6-4377-afde-f9ea05103307_20250129T21:16_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name's [PII], and I recently, um, I have submitted a UB 92, um, to have my, uh, it's, this has been going on and on trying to get it to you guys and I got it to you guys and um I got two notifications I might uh needed, you might need additional information then I got another one. I need the itemized hospital bills with it.
[CUSTOMER][NEGATIVE] Admission and discharge dates and times and then I did get check where you paid, gave me $100 for the, actually I, I, I pay claims myself so I know what this so for the um CPT 99285 but on my hospital bill, I don't understand why you guys aren't going through that because I said, I faxed you the whole UB that has the admission and discharge date.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Let me get your policy number, [PII].
[CUSTOMER][NEUTRAL] OK, the policy number is 024.
[CUSTOMER][NEUTRAL] 35427 and I apologize I'm losing my voice.
[AGENT][POSITIVE] OK, that's a good
[AGENT][NEUTRAL] OK, I understand. Uh, can I get your phone number?
[CUSTOMER][NEUTRAL] [PII] it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me pull up your file.
[CUSTOMER][NEGATIVE] I actually had to take a whole day off in order to be able to go.
[AGENT][NEUTRAL] To take care of it. I know.
[CUSTOMER][NEGATIVE] Yeah, because that, I mean this has been a nightmare because I didn't know Saint Luke's doesn't file with indemnity.
[CUSTOMER][NEGATIVE] I found that out last minute. It, it, it's just run around. It's been terrible, and I'm like I've been paying, I was paying $200 a month for this insurance and I'm not getting anything reimbursed. I was, I was able to get the $100 check the other day, but
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's
[AGENT][NEUTRAL] Right
[CUSTOMER][NEUTRAL] That's, that's not compared to how expensive my hospital bill is.
[AGENT][NEUTRAL] And that for ER? Right. Right. What's your date of birth and your address, [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your email address?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So let me take a peek here and see.
[AGENT][NEUTRAL] Now you're stating that you believe that you submitted the requested information?
[CUSTOMER][NEUTRAL] Yeah, I actually it's the UB.
[AGENT][NEUTRAL] OK, so in order to process your claims, we need the itemized hospital bills with the admission and discharge dates, um, so the itemized bill includes the admission and discharge dates and times or did you send?
[CUSTOMER][NEUTRAL] And you go.
[CUSTOMER][NEUTRAL] Yeah, I mean, it's on the UB 92. I mean, I've been processing claims since the [PII].
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] So the the admit and the discharge dates and time, is that included in what you sent?
[CUSTOMER][NEUTRAL] Of course it's on the UB 92, the claim form.
[AGENT][NEUTRAL] OK, OK. Let me look at it.
[CUSTOMER][POSITIVE] Yeah, if you, I mean, I like I said, I've been paying claims for years. That's why I like.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, who do you process for?
[CUSTOMER][NEUTRAL] Well, I, I work for a vendor of Blue Cross.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But yeah, if you look it shows the from date is [PII]. I mean it's got everything on there.
[AGENT][NEUTRAL] Oh, OK, let me take a peek.
[CUSTOMER][NEUTRAL] Shows the current date [PII] and also [PII] on there on the UV.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean if you need I can, I mean I can fax you the one little gal there just send me an itemized um.
[CUSTOMER][NEUTRAL] Thing in medical services if you guys need that too but I didn't understand why that would just work with the.
[AGENT][NEUTRAL] What's
[AGENT][NEUTRAL] What's on that document?
[CUSTOMER][NEUTRAL] Well, I figured the UV would be sufficient, but I mean it, it's got.
[CUSTOMER][NEUTRAL] Uh, I mean, it's an itemization of my medical services. If you need me to fax that to you, I guess I can do that as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] This is a huge hospital bill.
[CUSTOMER][NEUTRAL] I just thought that you should be sufficient, but.
[AGENT][NEUTRAL] So when I'm looking at the UBO 4.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] It looks like the top of this one might be, let me see.
[AGENT][NEUTRAL] Was, were you admitted [PII] and [PII]?
[CUSTOMER][NEUTRAL] Yeah, yeah, it, yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I mean I do if you need it I wouldn't I mean we don't request this when I pay claims, but it I mean I do have an itemized thing that shows my sterile stuff blah blah blah.
[CUSTOMER][NEUTRAL] The whole 9 yards if you need that that I thought that you'd be be sufficient.
[AGENT][NEUTRAL] Were you admitted through the emergency room?
[CUSTOMER][NEUTRAL] I was a nurse through the ER, yes.
[AGENT][NEUTRAL] OK. Give me 1 2nd.
[AGENT][NEUTRAL] Um, I believe that why we're asking for the admission and discharge times because when I looked through um.
[AGENT][NEUTRAL] There is no um.
[CUSTOMER][NEUTRAL] Is it not on that you let me look at it again.
[AGENT][NEUTRAL] Yeah, it, it gives the admin and the date that you were released, but because you, you were admitted through the uh operate it doesn't show any observation hours on here and there are no room and board charges on here. That's why they're asking for the admission date and the times.
[AGENT][POSITIVE] The days are clear.
[CUSTOMER][NEUTRAL] The mission and date.
[AGENT][NEUTRAL] Yeah, I see the 47 through 49, but in the body of it, you know, it usually have if you were admitted, it'll have an admit charge.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And it doesn't and I don't see a observation charge.
[AGENT][NEUTRAL] You know, like they held you in ER for so many hours and then maybe put you in a room, considering it admit.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Uh, they actually, they got me a room right away.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And I'm looking at my itemized bill they gave me too and if I mean.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Which I didn't send that with my stuff but um.
[AGENT][NEUTRAL] What's on that one?
[CUSTOMER][NEUTRAL] Well, it shows on [PII]. It's, I mean I can send this to you. I don't know.
[CUSTOMER][NEUTRAL] If that's gonna help any or not?
[AGENT][NEUTRAL] Is
[CUSTOMER][NEUTRAL] Because it doesn't look like it has the time either.
[AGENT][NEUTRAL] Usually, um, so usually they have the documentation kinda in the medical records. Um, it's usually that face sheet of your admission time and date and your discharge time and date. So it's not, it's not on this UBL4 that I'm looking at. I will say that, so that's
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So this um itemization it's just got and discharge it doesn't have the dates and times either so.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And I'm saying usually in your medical notes.
[AGENT][NEUTRAL] Um, so this is, I guess it's pretty much like dictation. It's usually on that first or second page and it specifically states, you know what I'm talking about?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right, I
[CUSTOMER][NEUTRAL] Uh, of course, I, like I said, I take claims since the [PII].
[AGENT][NEUTRAL] Maybe you can get a copy of that because it's not on the UV 92.
[CUSTOMER][NEUTRAL] Yeah, I
[CUSTOMER][NEUTRAL] Yeah, it's not on the UB and like I said um.
[CUSTOMER][NEUTRAL] It's also this itemization I could send you not on there either so.
[CUSTOMER][POSITIVE] But, um, OK, I'll love that.
[AGENT][NEUTRAL] So could be a part of your records.
[CUSTOMER][NEUTRAL] I've been getting, yeah, I might see if they can just send me the medical records somehow.
[AGENT][NEUTRAL] To, to include the admission dates and times.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I don't know if they'll mail those or not. I have to pick those up.
[AGENT][NEUTRAL] Are you far from the hospital?
[CUSTOMER][NEGATIVE] No, but I, I've been working, I've been working, I, we've been working 50, 60 hours. They got rid of a whole bunch of people back in.
[AGENT][NEUTRAL] OK. I have to take off.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Uh, yeah, so I'm actually on my break right now calling you on the 1 week, so.
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] I'll see what I can do.
[CUSTOMER][POSITIVE] I, I appreciate your help, [PII].
[AGENT][NEUTRAL] Oh, you're welcome. Did you have any other questions? Hm.
[CUSTOMER][NEUTRAL] And then I guess that $1 check got for the ER I can cash that from you guys so.
[AGENT][POSITIVE] You can. Yeah, you can.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Alright darling, I'll see what I can do. I'm gonna call them here in a little bit.
[AGENT][NEUTRAL] OK. All right, [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] You have a great day.
[AGENT][POSITIVE] Thank you too. Thanks for calling APL. Have a good day as well.
[CUSTOMER][NEUTRAL] Uh bye.