AccountId: 011433970860
ContactId: 33df40dc-4ea2-43df-9616-765e0232698f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 890039 ms
Total Talk Time (AGENT): 335983 ms
Total Talk Time (CUSTOMER): 187322 ms
Interruptions: 2
Overall Sentiment: AGENT=0, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/33df40dc-4ea2-43df-9616-765e0232698f_20250502T13:28_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from Prada's office to check on a claim status.
[AGENT][POSITIVE] OK, well I'll be more than happy to help you with the claim status, [PII], and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] It's 02555046.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And how many clients do you have in total today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do have one claim.
[AGENT][NEUTRAL] Alright, and can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] with the date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And can you verify I'm sorry, um, can you provide the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] Yes, it's [PII], with the bill amount, $288 even.
[CUSTOMER][NEUTRAL] And I do have a specific question.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] OK. And then what question did you have?
[CUSTOMER][NEUTRAL] Uh, previously, the check was made to an incorrect address. So we have submitted the W9 form and it was received on [PII].
[CUSTOMER][NEUTRAL] And it was being updated on [PII]. And I want to know the check status, Reiss check status right now.
[AGENT][NEUTRAL] So, I only see the original and the paid um that we paid back in [PII] $53.89.
[CUSTOMER][NEUTRAL] Uh, whether it was being cashed or not?
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] And can you just to make sure, can you verify the name of the, your provider's office, the facility name?
[CUSTOMER][NEUTRAL] Holy Cross Medical Group.
[AGENT][NEUTRAL] OK, I just want to make sure, hold on one moment.
[AGENT][POSITIVE] Um, so that's check number 2026498. I'm showing that it's still outstanding.
[CUSTOMER][POSITIVE] Uh, still outstanding. OK, I got it for that. And uh previously, we have submitted the W and regarding the
[CUSTOMER][NEUTRAL] Payment and it was being paid to an incorrect address. So we have submitted the W9 form. If you want, I can help you with that uh tracking ID.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] What is the address that the that the, what is the address that the payment is supposed to go to?
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] So, supposed to two is [PII].
[AGENT][NEUTRAL] Hold on one moment. Hold on, hold on. I'm typing. Can you please slow down [PII]?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Is it alright if I place you on a brief hold?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Is it OK if I place you on a brief hold?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Wait, wait, wait, wait, wait, wait.
[AGENT][NEUTRAL] So, this is the original from January.
[AGENT][NEUTRAL] They called us in March.
[AGENT][NEGATIVE] told us that this check was sent to the wrong address.
[AGENT][NEUTRAL] Then I just check that. Hold on.
[AGENT][NEGATIVE] And that was sent to the PO box that he's now saying is the wrong address.
[AGENT][NEUTRAL] Is that correct?
[AGENT][NEUTRAL] That is correct. So, January check.
[AGENT][NEGATIVE] They called in March and said it was the wrong address and reissued, so we voided it.
[AGENT][NEGATIVE] Then they called in April to say that it was the wrong address and sent the W9. What?
[AGENT][NEUTRAL] That's the reissue.
[AGENT][NEUTRAL] Right, that's the reissue.
[AGENT][NEUTRAL] So they called us in January. Wait.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] We finished it in January. They called us in March.
[AGENT][NEUTRAL] So we voided it.
[AGENT][NEUTRAL] And then in April, I mean, what? They called us in March, something.
[AGENT][NEGATIVE] I'm sending it back.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. So, OK, there's
[AGENT][NEUTRAL] Let me get the other address up. Hold on one moment so that I can get the right one.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So there's two addresses, the [PII], and then there's the one in [PII]. The original claim check was sent to the PO box that you're saying is correct, but we were told to then void that and send it to the
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] I think.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Address in [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So which address is correct?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The correct address is [PII].
[AGENT][NEUTRAL] OK, because that's where the original check was sent to back in January, and we were told that was incorrect.
[CUSTOMER][NEUTRAL] OK. Could you please, uh, as we have already crossed, uh,
[CUSTOMER][NEUTRAL] So more than 30 days. Could you please reissue the check for the same address which, which it was being sent to the correct address [PII].
[AGENT][NEUTRAL] That's the check that was voided. So the check that was paid.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] So the check that was then reissued was reissued to the [PII] address that was given.
[CUSTOMER][NEUTRAL] OK. So when was the reiss uh check has been reissued?
[AGENT][NEUTRAL] Hold on one moment, let me get that for you.
[AGENT][NEUTRAL] It was reissued on [PII].
[CUSTOMER][NEUTRAL] [PII], uh, OK. Well, just a minute.
[CUSTOMER][NEUTRAL] So, uh, it was been cashed or not?
[AGENT][NEGATIVE] No, as I stated, it has not been cashed, but this was sent to the [PII] because we were told to void the PO box.
[AGENT][NEUTRAL] So we wouldn't
[CUSTOMER][NEUTRAL] No, actually, that is.
[CUSTOMER][NEUTRAL] Uh, that worked, uh, as it was been in, uh, it was been an error. So could you please void this check and send it for [PII]?
[AGENT][NEUTRAL] So we're now going to need another um W-9 or corrected claim with the PO box on it because we had that there and we were told that it was voided. So, I'm sorry, we were told that it was the wrong address and to send it to the federal highway. So now the [PII] highway is on file.
[AGENT][NEUTRAL] Let me do this. Do you mind if I place you on just a brief hold? Um let me uh see if I can get a claims examiner on the line for you, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, hold on one moment, but before I do that, um, was there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] No, uh, call reference number for me, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so the call reference number is going to be my name and today's date again, that's [PII] to my last name is [PII].
[CUSTOMER][POSITIVE] OK, got it. Thanks for that information.
[AGENT][NEUTRAL] You're very welcome. Um, hold on one moment.
[AGENT][NEUTRAL] Alright, hold on one moment, OK?
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm she said get on the claims report.
[CUSTOMER][NEUTRAL] s f er ring
[CUSTOMER][POSITIVE] And thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you doing?
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] I'm doing good. Um, I have a provider on the other line. Um, can I give you the policy number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Alright, it's 2555046.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it's claim number is 3548075.
[AGENT][NEUTRAL] And 356-053-3.
[AGENT][NEUTRAL] So the original claim,
[AGENT][NEUTRAL] The check was sent to a PO box in [PII].
[AGENT][NEGATIVE] They called us and told us that it was the wrong address, so we voided it and we sent the one in February to the address, you know, from the corrected claim that they sent in. Well, now the providers on the line saying that that from the corrected claim is the wrong address, we should have sent it to the PO box in [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I told him, OK, well, we'll need to correct the claim with the PO box because we were told to switch it to this one in [PII].
[AGENT][NEGATIVE] He's not understanding.
[CUSTOMER][NEUTRAL] Actually we're gonna need a W9. We need a W9 so that we'll know exactly where it needs to go.
[AGENT][NEUTRAL] OK, um, he did say that he'll send the W-9. Um, he's not, but he's not under, he wants to talk to somebody because he's not understanding why we I just can't send it to be voided because it's
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The two addresses.
[AGENT][NEUTRAL] And um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Usually I will send a hub, but I was told to get them to claim that they don't understand, so that's what I'm doing.
[CUSTOMER][NEUTRAL] Mm that's fine send them on over.
[AGENT][NEUTRAL] All right, thank you, [PII]. Hold on one moment.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][POSITIVE] Good morning thanks for calling. I'm sorry.
[AGENT][POSITIVE] Oh sorry [PII]. I have [PII] on the line with claims and she'll be assisting you further, OK?
[CUSTOMER][POSITIVE] OK, thanks for that. Hi, this is [PII].
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Good morning. Thank