AccountId: 011433970860
ContactId: 7f787945-0e3e-4930-8180-3bb083a26e2c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 359619 ms
Total Talk Time (AGENT): 169485 ms
Total Talk Time (CUSTOMER): 111531 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/7f787945-0e3e-4930-8180-3bb083a26e2c_20250415T12:55_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I need to check status on the claim, please.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII]. 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] Excuse me. 02337106 ML 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] [PII] in the amount of $1,846.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] All right, and [PII], is it OK if I place you on just a brief hold while I pull the claim?
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So that like I don't have to add it up, so let me just see if this is all the claim.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Alright, so let's start from the bottom 356-507-73574574.
[AGENT][NEUTRAL] Is it?
[AGENT][NEUTRAL] 7
[AGENT][NEUTRAL] 74 and 10.
[AGENT][NEUTRAL] This 10, because something was voided, so let me see.
[AGENT][NEUTRAL] 77 is the original, but that was voided so then it's probably this one.
[AGENT][NEUTRAL] We paid, we forwarded it, and we reissued it.
[AGENT][NEUTRAL] same thing let me see.
[AGENT][NEUTRAL] This is it, yep.
[AGENT][NEGATIVE] So this is the issue.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] 77.
[AGENT][NEGATIVE] It's void and I don't know what that that one's voided too.
[AGENT][NEUTRAL] OK, so this is the only, well, I'm gonna keep that just in case because sometimes they ask about the other ones.
[AGENT][NEUTRAL] OK, let's see if.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. And so I have the claim here. Um, can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Baptist Outpatient Services.
[AGENT][NEUTRAL] Alright, so we received this claim um a few times. The original claim was voided and reissued. Are you wanting the reissued claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, so we received it on [PII], well, we reprocessed it on [PII]. That claim number is 3,585,710.
[AGENT][NEUTRAL] And on [PII], um, there was a payment of $70 made to the provider.
[AGENT][NEUTRAL] Um, did you need the check information?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Alright, so it's check number 203.
[AGENT][NEUTRAL] 7451.
[AGENT][NEUTRAL] So single check?
[AGENT][NEUTRAL] It was mailed to [PII]. Is that the right address?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] No, it's not.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It should have been sent to, let me see what address do we have on the plane.
[CUSTOMER][NEGATIVE] Should have been sent to our PO box um.
[CUSTOMER][NEGATIVE] Yeah, cause what happens when it's sent to the facility, we never get them.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Um, let me see, should have been sent to our PO box. What do we have on?
[AGENT][NEUTRAL] Hold on one second, I'm just pulling the document so I can.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And I see why you guys sent it to the [PII].
[AGENT][NEUTRAL] Alright, so here's the thing.
[AGENT][NEUTRAL] Yeah, that's what's listed for the billing provider. So we'll need to receive a corrected claim with that correct whatever address we're supposed to send it to in that [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] I, why do they do this? They drive me crazy. My billing department really, really, really something special. OK. Thank you so much, [PII]. Um, and you have a wonderful.
[AGENT][NEUTRAL] Yeah, well.
[AGENT][NEUTRAL] Um, wait a minute, so.
[CUSTOMER][NEUTRAL] Let me see what do you recommend we do?
[AGENT][NEUTRAL] Um, so you're gonna send the corrected claim, right?
[CUSTOMER][NEUTRAL] Yeah, I'm gonna have to because uh I mean.
[AGENT][NEUTRAL] OK, I'm gonna
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yeah, yeah, because, because what happens is when the claim.
[CUSTOMER][NEUTRAL] It said it's a 50/50. Sometimes we end up getting the payments eventually, but.
[CUSTOMER][POSITIVE] Let me give it some time. Let me give it some time. Let's hope that they forward it to us.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, let me give it some time. If not, then if I come across again and I don't receive it, then we'll just submit a corrected claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Well, I'll go ahead and note the policy. And was there anything else I could assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, that would be it. Thank you so much, [PII] and you have a wonderful rest of the day.
[AGENT][POSITIVE] Thank you, you too, and thanks for calling APL.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.