AccountId: 011433970860
ContactId: 14b968b7-3f1b-4043-9711-d192b0e28670
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 941940 ms
Total Talk Time (AGENT): 311417 ms
Total Talk Time (CUSTOMER): 339728 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/14b968b7-3f1b-4043-9711-d192b0e28670_20250226T17:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII]. I'm calling from provider office for location claim status.
[AGENT][NEUTRAL] And you said your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And may I please have a callback number?
[CUSTOMER][NEUTRAL] Yes, [PII], no extension.
[AGENT][NEUTRAL] And may I please have the policy number?
[CUSTOMER][NEUTRAL] Yes, policy number ID is 02212533 M as in Mary L as in Lima A.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII].
[CUSTOMER][NEGATIVE] are on severe.
[AGENT][NEUTRAL] Date of birth, please?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And thank you so much [PII], for verifying the policy. You're calling in for status. May I please have the date of service and total bill?
[CUSTOMER][NEUTRAL] Yes, ma'am. Uh, this patient has, uh, we have three different data services. The first one is [PII] and bill amount $180.59.
[AGENT][NEUTRAL] And that was 5:30 of 24 total bill 180 59.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] I'm pulling that up for you now.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So for that claim it does show that we received it on 115-24.
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] That claim number is 352.
[AGENT][NEUTRAL] 7962. That claim processed and it made a payment in the amount of $52.33.
[CUSTOMER][NEUTRAL] Yes, ma'am, uh, the payment is a check or via credit card or EFT net.
[AGENT][NEUTRAL] It is via check.
[CUSTOMER][NEUTRAL] It's a paper check, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] May I know the payment details, please?
[AGENT][NEUTRAL] The check number is 20.
[AGENT][NEUTRAL] 12808.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Is a single check on the bulk amount?
[AGENT][NEUTRAL] It is a single chick.
[CUSTOMER][NEUTRAL] Uh, would you mind checking that the check is already been cleared or stay outstanding?
[AGENT][NEUTRAL] I will have to send a verification and it can take up to 24 to 48 hours.
[CUSTOMER][NEUTRAL] OK. Um, do you happen to know the, the address that the check was sent it to?
[AGENT][NEUTRAL] You will have to verify that mailing address we did submit it to the one that was listed on the claim. Would you like to verify that with me, please?
[CUSTOMER][NEUTRAL] Yes, that will be the claim on the address is 44,700.
[CUSTOMER][NEUTRAL] Um one second real quick.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That's not the mailing address that is listed on this claim.
[CUSTOMER][NEUTRAL] OK. So that will be the the another uh address that [PII].
[AGENT][NEUTRAL] That's not the mailing address that is listed on this claim.
[CUSTOMER][NEUTRAL] So maybe, give me one second, let me pull the claim.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That's the facility address, ma'am.
[CUSTOMER][NEUTRAL] So you have, you are not able to see that the check is the outstanding or cash and pay 24 hours to submit and get the verification from the uh payment department.
[AGENT][NEUTRAL] Correct, correct. It was submitted to that mailing address that was listed on file.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if that's supposed to be a different mailing address that needs to be an updated claim that would have to be submitted in with the correct mailing address listed.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yes, ma'am. Yes, we'd like to update the W9, the correct mailing address to, to the paper check sent to, and who do I have to contact to?
[AGENT][NEUTRAL] Only way that we can do that, we will have to get the verification done first. If that verification comes back that it has not cleared, then a check can be reissued, but as I stated, we will have to have that W9 and that new claim number, that claim with the correct mailing address, and that information can be submitted in via fax. Are you ready for that?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] That fax number is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And that is a pension claims department.
[CUSTOMER][NEUTRAL] OK. When I submit that uh uh claim department with the W9 and do I need to uh put the claim ID number that you just provided with the check information to reissue this to the correct, uh, payment address?
[AGENT][NEUTRAL] We still have to receive an updated claim, and box 33 has to have the correct mailing address.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] According to this claim, the [PII] is still the same facility address, so.
[AGENT][NEUTRAL] Yes, so it has to be updated with the correct mailing address that you're requesting for it to be submitted to.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, I will, I will request that in there.
[CUSTOMER][NEUTRAL] Our our our billing department to update that.
[AGENT][NEUTRAL] So once you submit in that W9 and that other needed information, that claim will have to come in with that documentation and then that claim will be reprocessed with the correct information and the W-9 and correct mailing address will be entered in the system.
[CUSTOMER][NEUTRAL] Yes, yes, ma'am. I will, I will do that. I will fax it with the 9 is, uh, the claim information on the above 33 is updating with the current uh mailing address and we will fax it to for the review.
[AGENT][NEUTRAL] OK, and is there another claim number that you need me to review as well?
[CUSTOMER][POSITIVE] All right. Thank you.
[CUSTOMER][NEUTRAL] Yes, ma'am. Uh, that, that's the same patients and different uh data service that will be in [PII].
[AGENT][NEUTRAL] Total bill.
[CUSTOMER][NEUTRAL] Total bill is $225.49.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] And I'm pulling that claim up for you now.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And also for the previous claim before I can make note of it as well, what is the correct mailing address that it would have to be issued to?
[CUSTOMER][NEUTRAL] Yes, uh, the current mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me make sure I have this correct. That is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] 73. OK, thank you.
[AGENT][NEUTRAL] And so for that claim, it does look like we did receive it and process and make a payment and the receipt of that claim was [PII].
[AGENT][NEUTRAL] It was processed on [PII]. That claim number is 3562175. It shows that it processed and it made a payment in the amount of $38.74.
[CUSTOMER][NEUTRAL] Is it also the uh check on the uh EFT?
[AGENT][NEUTRAL] That would be via check.
[AGENT][NEUTRAL] Let me pull that up for you.
[AGENT][NEUTRAL] It shows that the check number is 2027183.
[AGENT][NEUTRAL] And with that check just being issued on 211, if it was issued to the incorrect mailing address, it still have to allow a total of 30 business days before that check can be voided and reissued.
[CUSTOMER][NEUTRAL] OK. So, um, we have, even though the, uh, this
[CUSTOMER][NEUTRAL] But uh paper check is going to W9 is on the [PII]. The billing address is [PII].
[CUSTOMER][NEUTRAL] That's the one is the uh.
[CUSTOMER][NEUTRAL] And above 33.
[AGENT][NEUTRAL] So that would be the one that the check was issued to.
[CUSTOMER][NEUTRAL] OK. Either [PII], or you can either submit it to the [PII]. That, that will be fine. But W9 is showing just [PII].
[AGENT][NEUTRAL] So for this, for this claim, it was issued to that physical address which is the [PII] exchange, and that was done on [PII].
[CUSTOMER][NEUTRAL] OK, that, that, that is, that is fine. 4700 also fine by me, yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So this claim that the check that issue is no need to be updated and reissue it to today because this is signing to the correct address.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, ma'am. This check that you just stated that 2027183 is that the checking check or the book amount?
[AGENT][NEUTRAL] It is a single check.
[CUSTOMER][NEUTRAL] OK. Would you mind checking another data service for that, this patient?
[AGENT][NEUTRAL] May I have the date of service, please?
[CUSTOMER][NEUTRAL] Yes. That will be [PII] and bill amount is $225.49.
[AGENT][NEUTRAL] So for that claim it shows that we received it on [PII]. It was processed on [PII]. That claim number is 356-4451. That claim showed that it processed and it made a payment in the amount of $38.61.
[CUSTOMER][NEUTRAL] $38.61 OK.
[CUSTOMER][NEUTRAL] There is a total balance of $98.61 but it's only paid $38.61 for the. There's a three CPT code 99214 1190 and J 3301. Which CPT code got paid and which ones got the 9?
[AGENT][NEUTRAL] The one that was denied was the 99214. It denied that office visits are not covered under the patient's plan.
[CUSTOMER][NEUTRAL] May I know the check number and book amount?
[AGENT][NEUTRAL] The check number is 202.
[AGENT][NEUTRAL] 863 7.
[CUSTOMER][NEUTRAL] Is a single gene.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So this check if they are submitted to the 4,700,183,110.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] You're welcome. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] OK, that will be for this call and you are very helpful. And do you have a call reference number as well?
[AGENT][NEUTRAL] The call reference would be my first name, [PII], which is spelled [PII] last initial [PII] [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you very much for your help, [PII].
[AGENT][POSITIVE] You're so welcome and thank you for calling American Public Life Ma. Have a great rest of your day.
[CUSTOMER][NEUTRAL] You do the same. Bye-bye.
[AGENT][POSITIVE] Thank you.