AccountId: 011433970860
ContactId: dd78606d-654c-4bb8-aa26-b9575eb18546
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 397869 ms
Total Talk Time (AGENT): 142103 ms
Total Talk Time (CUSTOMER): 160641 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/dd78606d-654c-4bb8-aa26-b9575eb18546_20250312T16:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm trying to see if you guys ever received a claim and if you did where it's at in processing.
[AGENT][POSITIVE] OK, so I'm happy to check on a claim for you today. Do we have the policy number?
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Um, I have 023375-04 Mary Lincoln 8.
[AGENT][NEUTRAL] Alright, let me take a look here. Is this a claim that you submitted for yourself or are you calling from the provider's office?
[CUSTOMER][NEUTRAL] Nope, we are calling. I'm calling from Bail Valley Surgery Center. Um, you guys are secondary payer.
[AGENT][NEUTRAL] OK. Uh, let me just get the patient name and date of birth, please.
[CUSTOMER][NEUTRAL] Patient's name is [PII] [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Alright, perfect, thank you for that and then what's the date of service?
[CUSTOMER][NEUTRAL] Data services [PII], uh, total charges were 20,000.
[CUSTOMER][NEUTRAL] I'm sorry, $2070 and it looks like we billed this to you guys back in [PII] by paper and it went to [PII], Miss [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And this is [PII], right? I'm losing my mind today. Um [PII].
[AGENT][NEUTRAL] Yeah, no, it's OK.
[AGENT][NEUTRAL] No, no worries. OK. And the billed amount was for $2070 you said?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Do you have an amount after the primary that's maybe different or is that the amount?
[CUSTOMER][NEUTRAL] 3, well, the total that was left over after primary paid was $329.46.
[AGENT][NEUTRAL] Hm OK, let me see.
[AGENT][NEUTRAL] So I have one claim for that date of service, [PII], but the charge amount I'm seeing is $1,966.50.
[AGENT][NEUTRAL] 26 let me see.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] And it was for Val Valley Surgery, is that correct?
[CUSTOMER][NEUTRAL] The Valley Surgery Center in [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Hm, OK. So yeah, it looks like we did get a claim for that. It looks like we received it showing [PII].
[AGENT][NEUTRAL] And there was a benefit payment sent.
[AGENT][NEUTRAL] Um, so it looks like
[AGENT][NEUTRAL] There was a benefit payment mailed in the amount of $1,637.04.
[CUSTOMER][NEUTRAL] OK, and so is there any way that you can email or um fax me a copy of the EOB and all of the payment information that we can maybe try and track that down because that is definitely a lot higher than what we were anticipating getting.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Yeah, absolutely, so let me send this.
[CUSTOMER][NEUTRAL] Oh wait, $1,634 1,637 dollars 4 cents. So yeah, I actually see that payment posted, um, so I don't know if we have a contraction. Was there any patient liability left over after you guys paid?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] So yeah, it looks like this was the maximum benefit um with that check for the date of service. So there was nothing additional payable on our end as far as anything remaining, that would be up to the facility or provider if they want to bill the patient for it.
[CUSTOMER][NEUTRAL] OK, so is there any way you can email or fax out a copy of that EOB and information to me so I can look at it. Um, we have an outstanding balance and we're trying to clear those off and without more information as to why that's sitting out there because this is in one of these accounts that are miscellaneous and we try and follow up as best we can.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yeah, no, I can absolutely, uh, I can fax this to you. What's a good fax number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm sorry, I'm giving you my direct line. Let me try that again [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right. And can I grab your first name again? I'm sorry.
[CUSTOMER][NEUTRAL] Yep, it's [PII]
[AGENT][NEUTRAL] Thank you, [PII]. Should I mark attention?
[CUSTOMER][NEUTRAL] Yeah, we, we have that
[CUSTOMER][NEUTRAL] Yep, attention to me would be great. Yeah, we have that 329 46 outstanding and so it might just be an adjustment that needs to be made or something along those lines, so getting that would be great. What was the claim number on that?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, claim number is gonna be 342-6720.
[CUSTOMER][POSITIVE] Perfect. All right, yeah, if you could fax that to me, that would be great.
[AGENT][POSITIVE] Absolutely. That is on its way, so you should have it in about 5 minutes, OK?
[CUSTOMER][POSITIVE] Perfect I appreciate it thank you so much.
[AGENT][POSITIVE] You're welcome. Anything else I can do for you today?
[CUSTOMER][POSITIVE] Nope, that would be it. Thank you so much for fixing that. I appreciate it.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL have a good one.
[CUSTOMER][NEUTRAL] Uh huh bye bye.
[AGENT][NEUTRAL] Bye bye.