AccountId: 011433970860
ContactId: f2b09b64-c5cb-48e9-9a16-73b97d937a2f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1110729 ms
Total Talk Time (AGENT): 293622 ms
Total Talk Time (CUSTOMER): 246639 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/f2b09b64-c5cb-48e9-9a16-73b97d937a2f_20250415T18:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I am uh calling with the medical provider's office and I am just checking status of
[CUSTOMER][NEUTRAL] A claim
[AGENT][NEUTRAL] OK, I can help you with claim status today. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it's gonna be the certificate is gonna be 02506284.
[AGENT][POSITIVE] OK, perfect.
[AGENT][POSITIVE] And then who do I have the pleasure of speaking with today?
[CUSTOMER][NEUTRAL] My name's [PII].
[AGENT][NEUTRAL] OK, [PII], so what's a good call back number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK. And then the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's gonna be [PII]. Date of birth [PII].
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And then do you have a data service and charge amount or a claim number?
[CUSTOMER][NEUTRAL] Yes, I have a date of service as [PII] for a total bill amount of $300.00.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] OK, just one moment.
[AGENT][NEUTRAL] Sorry, my computer is not liking me today.
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] See
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So, it looks like for claim number 3543287.
[AGENT][NEUTRAL] The received date was [PII] and the process date was [PII].
[AGENT][NEGATIVE] And this was denied.
[AGENT][NEUTRAL] Sorry, there's another claim number for this one.
[AGENT][NEUTRAL] It is 356-814-4.
[AGENT][NEUTRAL] This one's a more recent one. the received date, [PII].
[AGENT][NEUTRAL] And the process date, [PII].
[AGENT][NEUTRAL] I'll look at this one.
[AGENT][NEUTRAL] And then what provider's office were you calling from again?
[CUSTOMER][NEUTRAL] Uh, Doctor [PII].
[AGENT][POSITIVE] OK perfect thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so the second one I gave you was just a duplicate.
[AGENT][NEUTRAL] Uh, let me check the status for the other one.
[CUSTOMER][NEUTRAL] OK, that one I'm assuming denied as a duplicate.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] OK, so the 35432887 claim, it says office visits are not covered by the above number policy, so not covered by this meddling policy.
[CUSTOMER][NEUTRAL] OK, perfect. Is there any way that I can get that EOB for the denial?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me ask, I'm not sure. Just one second, OK?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Hey, thank you for holding.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] So it looks like the best way to locate that EOB would be on our OSC website if you wanted to create.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] A profile, it's [PII], or we can fax it.
[CUSTOMER][NEUTRAL] OK, uh, let's see.
[CUSTOMER][NEUTRAL] OK, I think I did find it's [PII].
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[CUSTOMER][NEUTRAL] OK, now I do have a question on the account number then.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is that what we have or is that the claim number that I can use?
[AGENT][NEUTRAL] Uh, let me see, it should.
[AGENT][NEUTRAL] The account number.
[CUSTOMER][NEUTRAL] Because I entered our tax ID and then it says the next step is the patient account number.
[AGENT][NEUTRAL] OK, do you guys have an OSC account with us?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK. Let me read.
[CUSTOMER][POSITIVE] So I'd be creating a new entirely.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so you'll go to [PII] and then you click on the new user tab.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and then.
[CUSTOMER][NEUTRAL] And then I selected I'm a medical provider.
[CUSTOMER][NEUTRAL] And then I entered our tax ID.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then it asks for an a patient account number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] But when I enter what would be listed on our claim, it doesn't pull up her information.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Or his information excuse me.
[AGENT][NEUTRAL] Yes, it says the patient account number must match the number you listed.
[AGENT][NEUTRAL] On the submitted claim form.
[AGENT][NEUTRAL] OK, and the
[AGENT][NEUTRAL] I can give you the patient's account number. Let's see.
[CUSTOMER][NEUTRAL] It should be what we have is the CEB 000 [PII].
[CUSTOMER][NEUTRAL] Which would be listed.
[CUSTOMER][NEUTRAL] On the CMS form that we would send to you guys for the claim.
[CUSTOMER][NEGATIVE] But it doesn't pull up anything for him.
[AGENT][NEUTRAL] OK, uh, let me look to see for the account.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] So you would type in 250.
[AGENT][NEUTRAL] 6284.
[CUSTOMER][NEUTRAL] OK, 2506284?
[AGENT][NEUTRAL] Yes. Mhm.
[CUSTOMER][NEUTRAL] OK, so no user was found with the information that was entered.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] That's weird. That's the policy number.
[CUSTOMER][NEUTRAL] Let's try again.
[CUSTOMER][NEUTRAL] OK, let's, oh, hold on.
[CUSTOMER][NEUTRAL] Let me take out all this information.
[CUSTOMER][NEGATIVE] And then when I enter the full tax ID it actually doesn't allow me to.
[CUSTOMER][NEUTRAL] Put in all the numbers.
[AGENT][NEUTRAL] Oh, that's weird. Um.
[CUSTOMER][NEUTRAL] Yeah, it cuts off the last digit so our tax ID is [PII] and when I put the last 0 it enters it into the account number like the patient's account number which is the next line.
[AGENT][NEUTRAL] Yeah, it should generate. Is there a 0 before that tax ID number?
[CUSTOMER][NEGATIVE] Oh, I don't believe.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] Is that tax ID still not working?
[CUSTOMER][NEUTRAL] Oh wait, here we go, what was that account number one more time?
[AGENT][NEUTRAL] It was [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mm mm there was an input with your error.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Let me look.
[AGENT][NEUTRAL] Hey, so try.
[AGENT][NEUTRAL] Try CE.
[AGENT][NEUTRAL] In all caps, C E B
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 000.
[AGENT][NEGATIVE] F G.
[CUSTOMER][NEUTRAL] Right, that's what I was saying in the beginning. I tried that because that's what's listed on our CMS claim form.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And it didn't work 78,070.
[CUSTOMER][NEUTRAL] And then when I enter our tax ID.
[CUSTOMER][NEGATIVE] It gives me there's an error with your input.
[AGENT][NEUTRAL] OK. What's the
[CUSTOMER][NEUTRAL] So the first box is.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] What's the tax ID that you have?
[CUSTOMER][NEUTRAL] The one that I'm entering is [PII].
[AGENT][POSITIVE] OK, that's right. That's what I have.
[AGENT][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] But it's weird the way it's set up there's like a box and then a dash and then a separate box.
[AGENT][NEUTRAL] Mhm. For the tax ID.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] So [PII].
[AGENT][NEUTRAL] I need
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So for the tax ID just enter [PII] [PII].
[AGENT][NEUTRAL] How many, how many numbers can you fit in there?
[CUSTOMER][NEUTRAL] Um, let me go back.
[CUSTOMER][NEUTRAL] OK, starting over.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] Let me go to the previous because it like cuts off. OK, [PII] is in the first box 5,978,070 well now it'll allow me to put all of them in there, but then it says there was an error there was an error with your input.
[AGENT][NEUTRAL] OK, so then go down to the patient account number and try to enter that again.
[AGENT][NEUTRAL] Maybe
[AGENT][NEUTRAL] That's why it's saying here.
[CUSTOMER][NEUTRAL] The account that you guys have?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Which uh the try the CEB.
[AGENT][NEUTRAL] 000 FG.
[CUSTOMER][NEUTRAL] FG, right?
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[CUSTOMER][NEUTRAL] Yeah, it doesn't
[CUSTOMER][NEUTRAL] I think it's the way the boxes are with the tax ID.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] So this sounds like it's probably gonna be a hassle. Can I just get you to fax it to us?
[AGENT][NEGATIVE] Yes. Yes, I don't, I don't understand why it's not working. OK.
[CUSTOMER][NEUTRAL] I don't either.
[AGENT][NEUTRAL] OK, what's your fax number?
[CUSTOMER][NEGATIVE] I don't wanna
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, you said [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK. I just, you kinda broke up in the beginning, so I wanted to make sure.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh sorry, yes ma'am.
[AGENT][NEUTRAL] OK. No, no, you're fine. It's just the phone.
[AGENT][NEUTRAL] OK. Is there anything else I can help you with today? Try to.
[CUSTOMER][POSITIVE] No, no, you've been helpful, thank you.
[AGENT][POSITIVE] OK, thanks for calling [PII]. I'll send this right over, OK?
[CUSTOMER][POSITIVE] OK, have a good one.
[AGENT][NEUTRAL] OK. You too. Bye.