AccountId: 011433970860
ContactId: d4f70149-0b90-4894-b39e-47248f3e4b2c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 426380 ms
Total Talk Time (AGENT): 166586 ms
Total Talk Time (CUSTOMER): 248321 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/d4f70149-0b90-4894-b39e-47248f3e4b2c_20250307T16:55_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 Emory University Hospital. I'm calling to check on claim status, please.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] It would be my pleasure to assist you with claim status, [PII]. What is the excuse me, what is the callback number, please, ma'am?
[CUSTOMER][NEUTRAL] It's it's [PII]. I'm [PII].
[AGENT][POSITIVE] Thank you, [PII]. I apologize for that little.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Um, speaking issues.
[CUSTOMER][NEUTRAL] I know I'm, I'm clearing my throat. I don't know if it's the weather or what's going on here, but uh.
[AGENT][NEUTRAL] Well, you know, it is that's it's getting to be that season.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So we, we'll just clear our throats and go home, won't we?
[CUSTOMER][POSITIVE] Wonderful.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] There's nothing else we can do. We have to, so.
[AGENT][NEUTRAL] That's right. That's right. What's the policy number for the patient?
[CUSTOMER][NEUTRAL] You know, is this correct? because it seems short 60801. I was just looking at that is that a group? Let me see if they have a card.
[AGENT][NEUTRAL] So that is
[AGENT][NEGATIVE] Yeah, no.
[AGENT][NEUTRAL] That's a payer ID.
[CUSTOMER][NEGATIVE] Oh jeez, why did they put no um you know we haven't received anything. We submitted this back in May of last year. Let's see if we have a copy of their card photo photo, um.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] No, can I give you a social? I hope we do have a social on this 10, we do. OK, OK, yeah.
[AGENT][POSITIVE] Yeah, we can do it. Hey, look out. That's good. Let me, let me get to that screen real quick.
[CUSTOMER][NEUTRAL] I'm thinking maybe unless they're able to determine, you know, after, let's see what happens.
[AGENT][POSITIVE] Let's see what's going on. I'm finally ready.
[CUSTOMER][NEUTRAL] He submitted it with the payer code? OK, we have 417.
[CUSTOMER][NEUTRAL] 080484
[AGENT][NEUTRAL] And what is the patient's last name?
[CUSTOMER][NEUTRAL] Uh, [PII], if I'm pronouncing it correctly, [PII] is the first name.
[AGENT][NEUTRAL] And [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Uh, let's see, we have [PII].
[AGENT][NEUTRAL] OK. I do have his policy pulled up. Let me give you his policy number before, yeah, and let me make sure that this is.
[CUSTOMER][POSITIVE] Oh, thank you.
[AGENT][NEUTRAL] His most current policy number, yeah, it is 234.
[AGENT][NEUTRAL] 4316.
[CUSTOMER][NEUTRAL] Now would that matter because it's a [PII] claim or is it still gonna be the same?
[AGENT][NEUTRAL] It'll be the same.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You said that was [PII]?
[CUSTOMER][NEUTRAL] Yes, yes, 35 to 36-2024 for 51,000. 0 wait, did they do, wait, did they do 50, let me see because I have.
[CUSTOMER][NEUTRAL] 0, 5,041,790 because primary um Blue Cross they paid $40,003.09 and they're leaving patient responsibility of 1,90791.
[AGENT][NEUTRAL] And that was a facility claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I do not have a claim on file and you said 35 to 36?
[CUSTOMER][POSITIVE] Pro.
[CUSTOMER][NEUTRAL] Yeah, probably because of that they put the you said the payer code in there, um.
[AGENT][NEGATIVE] Yeah, so you can actually there's no timely filing.
[AGENT][NEUTRAL] So it can actually, yeah, and you can actually fax it to our claims department with that primary EOB.
[CUSTOMER][NEUTRAL] You're no time is that? OK.
[CUSTOMER][NEUTRAL] What you mean?
[CUSTOMER][NEUTRAL] Did they update that?
[CUSTOMER][NEUTRAL] Oh, you, well, you know, they, OK, so they have this member ID. I wait, uh, they put on, wait, it is is wait you said well we have 02344316 then it has MBO on it. Would that be correct because they have it on here, but they didn't add it. They have the, well they had it on 023 what an actual claim it had the payer ID, but
[CUSTOMER][NEUTRAL] So you said the ID is 2234, right? 2344316?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So is that 0 to be on there or no?
[AGENT][NEUTRAL] Yeah, that's fine. And the email, yeah, that's fine too. It's not required, but it's fine if it's on there.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] Did they they the claims on here twice. Let's see.
[CUSTOMER][NEUTRAL] Uh, yeah, and let me see the next one.
[CUSTOMER][NEUTRAL] OK, they put on [PII] they did correct that and submit that. You don't see nothing coming in on [PII]?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Um, I don't have anything for the facility for those dates of service.
[AGENT][NEUTRAL] But you can you can fax it to us with the primary EOB.
[AGENT][NEUTRAL] Do you know, do they have the claim submission address? We can verify that as well.
[CUSTOMER][NEUTRAL] And your fax number?
[CUSTOMER][NEUTRAL] Oh yeah, because we, we have it is [PII].
[AGENT][NEUTRAL] So that is not our claim submission address.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] What is the correct address that it goes to?
[AGENT][NEUTRAL] Correct address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, wait, oh, I'm trying to sing that song. OK, uh, wait, how, OK, how do you spell?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Wait, OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] OK.
[AGENT][NEUTRAL] Yeah, [PII], [PII].
[CUSTOMER][NEUTRAL] [PII]. OK. And then the zip code?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Let me see, did they update that uh no, that's [PII].
[CUSTOMER][NEUTRAL] Did both of them go with the vegan address?
[CUSTOMER][NEUTRAL] Yes, let's see what the new one that they added on, see if that has the correct 10, it does. OK. So I have that. I can just, yeah, I can just, um, yeah, OK, I can add that then. OK. And can I have your call reference number, please?
[AGENT][NEUTRAL] Call reference number is my name and today's date.
[AGENT][NEUTRAL] And I spell my name [PII]
[AGENT][NEUTRAL] First initial and my last name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Well, thank you, [PII], and it's been a pleasure to assist you with that claim status. Did you want that fax number?
[CUSTOMER][POSITIVE] Nice talking to you.
[CUSTOMER][NEUTRAL] Oh sure.
[AGENT][NEUTRAL] Our claims fax number is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[AGENT][NEUTRAL] And anything else I can help you with?
[CUSTOMER][POSITIVE] Thank you. No. Have a great day and weekend. Bye.
[AGENT][POSITIVE] I hope you have a great day as well. Thank you for calling APL [PII]. Happy weekend. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Like