AccountId: 011433970860
ContactId: 7258616e-0810-47a0-9e80-e6d109ebf459
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1143209 ms
Total Talk Time (AGENT): 260100 ms
Total Talk Time (CUSTOMER): 159733 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=-1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/7258616e-0810-47a0-9e80-e6d109ebf459_20250103T17:30_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good morning. My name is [PII] and I'm calling to check status on a claim.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, Ms. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes it is.
[CUSTOMER][NEUTRAL] 02519236
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] All right. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] 9 1224 for $5,792.
[AGENT][NEUTRAL] That's 5,792.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and that was [PII]. OK.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me pull this ERB and for future, you can check claim status online through our website at [PII] and that's just optional.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] I'm waiting on the EOB.
[AGENT][NEUTRAL] OK. Um, is the procedure code G0121?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's a colonoscopy screening.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, OK. I got, OK, because I see it's been processed more than once. Um, let's see, um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] The process the first time and then it was voided and reissued. And this right here, what I'm looking at is the reissued of the $66.41 for code 43239 because um preventatives are not covered under the policy, so the G0121 is not covered. So we only cover the 6641 for code 43239.
[AGENT][NEUTRAL] So I see the last time we processed was [PII] and we send a check for that amount.
[CUSTOMER][NEUTRAL] On [PII].
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] OK, I don't see that we've received that. One second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you said it, it was in the amount of how much?
[AGENT][NEUTRAL] $66.41.
[CUSTOMER][NEUTRAL] And is it a check number or EFT? How, how was it sent?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's a check, um, it's a single check paper check.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And the check number is 2014391.
[CUSTOMER][NEUTRAL] And when was this? What's the date of the check?
[AGENT][NEUTRAL] Um, it's the same day as process, [PII].
[CUSTOMER][NEUTRAL] OK, is there, is there any way that we [PII], can we see, uh, can we check that check has been cleared?
[AGENT][POSITIVE] It's showing outstanding.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][POSITIVE] It's still showing outstanding?
[CUSTOMER][NEUTRAL] OK, so then we're gonna have to do a stop payment and have this reissued and verify exactly where it's being sent to because obviously we did not receive it.
[AGENT][NEUTRAL] OK, and this is the 2nd time we reissued, OK? Because this is already reissued. This is the reissued one. OK, so what is the address that it's supposed to go to?
[CUSTOMER][NEUTRAL] Yeah, so something
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Or [PII] it it doesn't matter it's the same um building [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me check something really quick.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] 75
[AGENT][NEUTRAL] We have to check the W-2 on this because the the suite is different. The one you're telling me, the one we have and the one in the system and the one we send prior was PO box so it's all different.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, the suite number that you might have also is it 302 because that's also us as well in the same building. It's 300, yeah, 300 is also us. That's if it wasn't there we should have gotten it.
[AGENT][NEUTRAL] It's 300.
[AGENT][NEUTRAL] It's 300.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, it is sent to the 300, that's where it went to.
[CUSTOMER][NEGATIVE] No, we have not gotten enough.
[AGENT][NEUTRAL] [PII] in [PII].
[CUSTOMER][NEUTRAL] And when, what is the updated W-9 that you guys have from when?
[AGENT][NEUTRAL] It looks like that one is the the most recent one, but let me check and see when we, when was it updated. One moment.
[CUSTOMER][NEUTRAL] Because
[AGENT][NEUTRAL] Yes
[CUSTOMER][POSITIVE] Bye have a good weekend.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me get the tax ID pulled off one moment.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] What is the tax ID?
[AGENT][NEGATIVE] Oh no, you
[CUSTOMER][NEUTRAL] 621
[CUSTOMER][NEUTRAL] 647-406.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 406.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 621-647-406.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Do you mind holding for me?
[CUSTOMER][NEUTRAL] No, go ahead.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[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] Thank you for holding and being patient for you Ms. [PII]. OK, I checked the whole system to see if I can find something different, but it looks like the last time that it was updated under that tax ID number, um, it was back in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I can send you a new one to see if we can have that reissued and sent to the right.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Address.
[AGENT][NEUTRAL] Yes, um, yeah, if you can just go ahead.
[CUSTOMER][NEUTRAL] Alright, um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, the right, um, suite number because that's what's what's happening.
[AGENT][NEUTRAL] Yeah, it's just that on the [PII] form it didn't have a suite. It was just the address without a suite number.
[CUSTOMER][NEUTRAL] OK, let me um.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And where can I send that to?
[AGENT][NEUTRAL] OK, you can either um fax it, mail it, um, let me see if you can email it, um.
[AGENT][NEUTRAL] No, just fax it or mail it. OK. So you can fax it, uh, the fax number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, you can put it
[CUSTOMER][NEUTRAL] [PII] mhm.
[AGENT][NEUTRAL] [PII]. Um, you can put our attention, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] And [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry, [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Phones.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, I'm sorry, I'm, I'm not understanding you, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And then this uh.
[AGENT][NEUTRAL] That will be [PII].
[CUSTOMER][NEUTRAL] OK, can you [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] No, [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Yeah, and please include the phone number uh to be contacted back if you need to call back or if they need to call you for any reason.
[CUSTOMER][NEUTRAL] OK, will do, thank you very much. Is there a reference number to this call?
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's name.
[CUSTOMER][NEUTRAL] OK, let me actually check if I have another one. Can I place you on a brief hold?
[AGENT][NEUTRAL] Sure, go ahead.
[CUSTOMER][POSITIVE] Thank you.