AccountId: 011433970860
ContactId: 5edf83d3-eb14-45d5-8b23-cfcdb502a73c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 806349 ms
Total Talk Time (AGENT): 209511 ms
Total Talk Time (CUSTOMER): 232423 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/5edf83d3-eb14-45d5-8b23-cfcdb502a73c_20250224T17:34_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, my name is [PII] calling you from provider's office, checking on claim status.
[AGENT][NEUTRAL] May I have a callback number?
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Yeah, sure, one second.
[CUSTOMER][NEUTRAL] That's 01066783.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] And may I please have the date of service and total bill?
[CUSTOMER][NEUTRAL] Yeah, date of service is [PII]. Total charge $459 even.
[AGENT][NEUTRAL] And that date of service is [PII], or 24 $458.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm pulling that information up for you now.
[AGENT][NEUTRAL] OK, could you verify the total bill charge again please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, sure. It is $459 even for the date of service, [PII].
[AGENT][NEUTRAL] So for that date of service it does show that we received that claim on 2/3 of 25. It was processed on 25 of 25.
[AGENT][NEUTRAL] Claim number 3560082. The claim processed and it made a payment in the amount of $25. Once that $25 was paid, that would be the maximum amount that could be paid out on this claim. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] OK. Uh, and, uh, may I know the mode of payment for this one?
[AGENT][NEUTRAL] Via check.
[CUSTOMER][NEUTRAL] OK. Can I get the check number?
[AGENT][NEUTRAL] The check number is 2026223.
[CUSTOMER][NEUTRAL] OK. And when was the check issued?
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] OK. Can you please verify me, it was a single check or check?
[AGENT][NEUTRAL] It will be a single chick.
[CUSTOMER][NEUTRAL] Of $25. I'm right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. And uh can you please verify me the check mailing address?
[AGENT][NEUTRAL] You will have to verify that with me. We mailed it to the mailing address listed on the claim.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sure. It is [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you. Can you check for the
[CUSTOMER][NEUTRAL] Yeah, just to confirm, the claim number is 3560082. I'm right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Can we check for the next patient?
[AGENT][NEUTRAL] So you're done with this claim?
[CUSTOMER][POSITIVE] Yes, I'm done with this. I can go for the next member.
[AGENT][NEUTRAL] May I have the policy number, please?
[CUSTOMER][NEUTRAL] Sure. It is 02443390.
[AGENT][NEUTRAL] That's 02443390.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is [PII] And the date of birth is [PII].
[AGENT][NEUTRAL] And may I have the date of service and total bill?
[CUSTOMER][NEUTRAL] Yeah, date of service is [PII]. Total charge $459 even.
[AGENT][NEUTRAL] So for that claim, it does show that we received it on [PII]. It was processed on [PII]. That claim number is 3557679. That claim processed and it denied that office visits are not covered under the patient's plan, and the other procedure codes denied that they were billed as zero.
[CUSTOMER][POSITIVE] OK. Sure, thank you.
[CUSTOMER][NEUTRAL] And I'm done with this patient. Can we check for the next member?
[AGENT][NEUTRAL] May I have the next policy number?
[CUSTOMER][NEUTRAL] Yeah, one second. It is 02555046.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] And may I have the date of service and total bill?
[CUSTOMER][NEUTRAL] Yeah, date of service is [PII]. total charge $288 even and uh have a specific concern regarding this claim.
[AGENT][NEUTRAL] And I did pull the claim up. How may I assist you on that claim?
[CUSTOMER][NEUTRAL] Uh, as per checking, this claim was allowed for $53.89 and it was paid with no patient responsibility upon checking this claim.
[CUSTOMER][NEUTRAL] The check has been paid to incorrect address. So we have submitted W9 form on [PII]. It was submitted through fax. Can you please check, have you received the W9 form?
[AGENT][NEUTRAL] I'm pulling the claim image up that we received.
[AGENT][NEUTRAL] And you stated that you sent NAW 9.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so we did receive documentation stating that the mailing address that was submitted was the correct mailing address.
[CUSTOMER][NEUTRAL] Oh, OK. Uh, can you please, uh, yeah, as per, uh, our previous colleague has documented the check mailing, uh, the check was issued to [PII]. To this address, the check was issued.
[AGENT][NEUTRAL] We was, we received documentation stating that that was the correct mailing address. We do have a W-9 on file.
[CUSTOMER][NEUTRAL] OK, sure. Uh, so how many days we need to allow?
[AGENT][NEUTRAL] You have to allow a total of 30 to 60 business days. Let me see when this check was issued. It was issued on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] And you stated that you submitted in a fax?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. And when was that fax submitted in?
[CUSTOMER][NEUTRAL] Yeah, the W9 was submitted on [PII].
[AGENT][NEUTRAL] Let me see if we received anything else in regards to another W9.
[AGENT][NEUTRAL] NW 9 was received on that for that claim with that mailing address so that claim was submitted and issued correctly per the documentation received.
[CUSTOMER][NEUTRAL] OK. When you have received the W9 form?
[AGENT][NEGATIVE] We received this W9 is not indicating when we received it. It's just showing that the W-9 is on file for that mailing address.
[CUSTOMER][NEUTRAL] That mailing address. OK. And just to confirm, the mailing address will be [PII]. I'm right?
[AGENT][NEUTRAL] No, the mailing address is [PII]. The correct mailing address that that check was issued to.
[CUSTOMER][NEUTRAL] OK, you mean you are stating this is the correct mailing address.
[AGENT][NEUTRAL] Yes, we received the W9 for that mailing address.
[CUSTOMER][NEUTRAL] OK. You have received a W9 for this mailing address. Have you received any W9 for
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] We haven't requested AW-9 for that mailing address. That mailing address has been entered previously.
[CUSTOMER][NEUTRAL] OK, you have been requested. OK. And uh may I have your name spell, please?
[AGENT][NEUTRAL] Yes, it is spelled [PII] last initial of [PII] and today's date will be the call reference.
[CUSTOMER][POSITIVE] OK, sure, it was great speaking with you. Have a good day bye bye.
[AGENT][POSITIVE] You're welcome. Thank you so much for calling American Public Life Sec. Have a great day as well.