AccountId: 011433970860
ContactId: f7314409-b621-43ed-97de-99fc338be7e2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 846640 ms
Total Talk Time (AGENT): 193154 ms
Total Talk Time (CUSTOMER): 154288 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/f7314409-b621-43ed-97de-99fc338be7e2_20250416T15:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] calling with Saint Mary's Regional Medical Center, checking on a claim, please.
[AGENT][NEUTRAL] I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Well, actually, I don't know if, if I'm checking on the the our claim got messed up because we needed to fax in a W-9 and we faxed that in back on 220, so I need to see if the claim is reprocessing, I guess I should say.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, got it. What's the policy number, [PII]?
[CUSTOMER][NEUTRAL] 02555592
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Direct line [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] I'm pulling up the policy, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Verify the patient's name and date of birth for me please.
[CUSTOMER][NEUTRAL] It is [PII] Date of birth [PII].
[AGENT][NEUTRAL] OK, and what's the um date of service and the charge?
[CUSTOMER][NEUTRAL] [PII] for [PII].
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] When was the um form submitted to us? You said in February?
[CUSTOMER][NEUTRAL] On [PII], yes.
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] Looks like maybe [PII] was handling it because the notes say [PII] was out of the office and all of that.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Right, right.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Did you fax it, was it faxed over to us, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Oh, it looks like it was faxed twice. You must not had it. So then it was faxed. Well, no, it was faxed on 220. I'm sorry, I'm losing my mind today.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I do see.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Are you [PII]?
[AGENT][NEUTRAL] Or [PII]
[CUSTOMER][NEUTRAL] Yeah, it's [PII], yeah.
[AGENT][NEUTRAL] OK, on the, on the cover sheet it says [PII]. OK.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] I'm gonna place you on a brief hold if you don't mind, OK?
[CUSTOMER][POSITIVE] That's fine thank you.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey, Ms. [PII], this is [PII]. How are you?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] [PII], can you hear me?
[CUSTOMER][NEUTRAL] OK, now I can hear you.
[AGENT][NEUTRAL] OK, so I have a provider on the phone, uh, let me give you the policy number and then the claim number and then I'll proceed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 255-5592.
[AGENT][NEUTRAL] And it's for part one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim number that I'm looking at is 356-688-8.
[AGENT][NEUTRAL] Originally denied, you know, the GM 6428 they sent the W-9.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Which is under this mail number for that claim, but we didn't pay anything we denied it again for the W-9.
[CUSTOMER][NEUTRAL] Mm, let's see here.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Why is that document not coming up?
[CUSTOMER][NEUTRAL] Here.
[AGENT][NEUTRAL] Are you in on base?
[CUSTOMER][NEUTRAL] Yeah, I'm in Onase. I was trying to look it up by the mail number because it's not attached to the claim when I pull it up.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] It's not. I had to pull it up by the policy number.
[CUSTOMER][NEUTRAL] OK, so let me do it that way then.
[CUSTOMER][NEUTRAL] OK, so yeah.
[CUSTOMER][NEUTRAL] That one it looks like.
[CUSTOMER][NEGATIVE] Yeah, nothing was paid on this claim. It need to be reprocessed.
[AGENT][NEUTRAL] So um I'll send a hub request or?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, all right, and I didn't know if that was the right one or if it was, you know, the W-9 if it's what we're looking for or.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah, it looks like they.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Didn't they need to be they need to be reprocessed, yeah.
[AGENT][NEUTRAL] Senate
[AGENT][NEUTRAL] OK. All right, I'll send a request.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, bye-bye.
[CUSTOMER][NEUTRAL] Mm bye.
[AGENT][POSITIVE] [PII], thank you so much for holding. So what I will do is I'm gonna route this directly uh to our claims team and then they will take care of it. So I apologize for that. It was received on the [PII] as you stated, so we're gonna request a rush on it.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, so once you request to rush on it, what kind of time frame are we looking at?
[AGENT][NEUTRAL] I mean allow at least 24 to 72 hours.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And so, um, give us today is what? um Wednesday?
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] May want to start us back on Friday.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And a call reference number please.
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII] and then first initial last name is [PII].
[CUSTOMER][POSITIVE] Perfect and you're rushing the claim itself, not just the update of the W-9, correct?
[AGENT][NEUTRAL] Both, both.
[CUSTOMER][POSITIVE] OK, alright, just wanted to make sure thank you so much I appreciate it.
[AGENT][NEUTRAL] Yeah, just want to update your your W-9 and before we can process it.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Hold on, hold on 1 2nd.
[AGENT][NEUTRAL] You're telling me that the claim was paid. Let me go back and look. I missed it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I think it paid to the patient, but it paid 0 from what I could tell.
[AGENT][NEUTRAL] Oh, let me see.
[AGENT][NEUTRAL] Let me take a look.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I'm gonna go ahead um I do see where it was uh reprocessed but they still want me to route it over to them so that they could take a look at it um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You know, so, um, we'll get that over today and then um you could call us um on Friday and status it and hopefully at that time, you know, we would have taken a look at it.
[CUSTOMER][POSITIVE] All right perfect thank you so much I appreciate it.
[AGENT][POSITIVE] Oh absolutely. [PII], do you have any other questions, [PII], I could help out with today?
[CUSTOMER][POSITIVE] That's it. Thank you.
[AGENT][POSITIVE] Uh huh you're welcome thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye bye.