AccountId: 011433970860
ContactId: 8bdf4912-7d07-4e37-b973-c3216352be1c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1149849 ms
Total Talk Time (AGENT): 400158 ms
Total Talk Time (CUSTOMER): 501410 ms
Interruptions: 5
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/8bdf4912-7d07-4e37-b973-c3216352be1c_20250320T17:36_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I'm calling from Madison Medical Center in [PII], and I'm not even sure if I pressed the right button to get to the correct customer service. We received a check from you and I need to speak with the accounts payable department I guess.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, but there wasn't that option to pick, um, so we've got a check that was actually made out to Mercy Clinic, but it's got our address on it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] We do have this patient in our system but can't figure out where this is supposed to go.
[AGENT][NEUTRAL] OK, well, I can.
[CUSTOMER][NEUTRAL] So I didn't know whether to mail it back to you guys or just if you could put me through to your accounts payable department.
[AGENT][NEUTRAL] We don't have an accounts payable department, um, but I'll be able to assist you. Um, [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] Thank you. May I have, oh go ahead. I'm sorry.
[CUSTOMER][NEUTRAL] And my extension is oh do you want the extension? I didn't know if you did or not.
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] 3302.
[AGENT][NEUTRAL] Thank you. And then so the what's the check number?
[CUSTOMER][NEUTRAL] The check number is 2032054.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, got a policy number. Hold on one moment.
[AGENT][NEUTRAL] For the patient, can you verify his first and last name and date of birth?
[CUSTOMER][NEUTRAL] Well, it says on here because I've got your policy number here as well. It's got the insured name of [PII]
[CUSTOMER][NEUTRAL] I've got a claim number on here and I've got their policy number on here.
[AGENT][NEUTRAL] Do you have their date of birth?
[CUSTOMER][NEUTRAL] And the data to serve it.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Not on your check, but let me look him up. I can get you that from our system.
[AGENT][POSITIVE] OK, take your time.
[CUSTOMER][NEUTRAL] I want 12.
[CUSTOMER][NEUTRAL] I really can't even tell you that because I've got more than one ray dot in here um I've got one.
[AGENT][NEUTRAL] Oh, it's OK. What's your patient's name?
[CUSTOMER][NEUTRAL] Well, the, the patient that you guys list on the check is the last name is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so it's for him. OK. I'm just asking if I can look at his claims to match the check to which claims so I know.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah. Do you want the claim number?
[CUSTOMER][NEUTRAL] That you guys have listed on your check? Yeah, I've got the whole thing here. I've got the policy number, the claim number.
[AGENT][NEUTRAL] Oh, you have the claim number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, sure, yes.
[CUSTOMER][NEUTRAL] Um, the claim number.
[CUSTOMER][NEUTRAL] The claim number is 357.
[CUSTOMER][NEUTRAL] 346 9.
[AGENT][NEUTRAL] 4.
[AGENT][NEUTRAL] Here we go.
[AGENT][NEUTRAL] And [PII], do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Alright, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, wait a minute.
[AGENT][NEUTRAL] So I need to look at these documents to see.
[AGENT][NEUTRAL] Oh, I think, I think most of the time.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK. So what's the problem?
[AGENT][POSITIVE] I that's the right thing. Let me see.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] All right, thank you so much for holding. I apologize for that wait. So I have all the I just needed to pull up the documents here. So you're saying that, OK, so it went to Mercy Clinic East.
[CUSTOMER][NEUTRAL] Oh, you're fine.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's made out to Mercy Clinic East Community.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But it's got our address, uh [PII]
[AGENT][NEUTRAL] So what is your, so this is what we're gonna have to do because that's the address. I pulled up the claim forms, that's the address that's on here, under the bill, the billing provider info.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Is there um
[CUSTOMER][NEUTRAL] Well, I don't have a [PII] on here or anything, um.
[AGENT][NEUTRAL] Oh, let me see.
[AGENT][NEUTRAL] It gave
[AGENT][NEUTRAL] So on one side, it says the service facility, that's Frederickstown, and then on the other side it says the Mercy East Community, which has the same address, but the, yeah, the difference on this form is the [PII] for the billing. So it should not go here.
[CUSTOMER][NEUTRAL] Well, I don't know that's what we were trying to figure out because there's no account number on there or anything to.
[CUSTOMER][NEUTRAL] To, uh, affiliate anything with so I, I don't know just I mean it's got [PII] on there, but it could be someone in his family or something, yeah, I don't have anything corresponding with ours because your the claim number I'm not, I don't know where to start with any of this on where it's supposed to go. So if you had gotten something from us.
[AGENT][NEUTRAL] Like patient account?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That would help me track down on this end.
[AGENT][NEUTRAL] Yes, I do have a patient account number that came over um from you, from you all. It starts with PSL.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is that what you're looking for?
[CUSTOMER][NEUTRAL] No, it should either start with a C or it should just be like an 8 or 9 digit number.
[AGENT][NEUTRAL] Let me see, 12345.
[AGENT][NEUTRAL] Yeah, on this claim on this claim form box 26 says patient's account number, but it says PSL 172754.
[CUSTOMER][NEUTRAL] Yeah, that's, that's what's on the check here too.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Well, I don't know.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Is there something else maybe I could provide for you?
[CUSTOMER][NEUTRAL] Well, I don't know whether to send the check back because.
[CUSTOMER][NEUTRAL] Uh, even though if it's supposed to be our check, it's still made out to Mercy Clinic East Community, and that's not Madison Medical Center. So I don't know where that Mercy Clinic East Community came from.
[AGENT][NEUTRAL] OK, wait a minute. So the name of, so I was getting Mercy in Madison. OK, so the name of your facility is Madison.
[CUSTOMER][NEUTRAL] Madison Medical Center.
[AGENT][NEUTRAL] OK, let me put that in my notes.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Because I started putting mercy. OK, hold on. I got the Ms mixed up. Madison Medical Center is where you're calling from, but on your, on this, OK, now.
[CUSTOMER][NEUTRAL] Yeah, on the check that we've got that was sent here, it's got our address, but the check is actually made out to Mercy Clinic East Community.
[AGENT][NEUTRAL] So you, so the address for Madison is [PII], also, it's just a different suite.
[CUSTOMER][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Is that what's happening?
[CUSTOMER][NEUTRAL] [PII] is our address, yeah, but.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, the Mercy Clinic East Community is what we're confused about because we're Madison Medical Center, so I wonder if this check was supposed to go to a [PII].
[AGENT][NEUTRAL] So it looks
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Facility and not us or if it's actually supposed to be our check which in either case, the check's not really written out to us so I would assume I would just mail it back anyway, no matter what because even if it was our check, I don't know what we would do as far as endorsing it because it's not made out to Madison Medical Center, so I'm just kind of don't know what to do.
[AGENT][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] Right. Let me reach out to claim. Um, I'm pretty sure you would just send it back, but I'm just gonna make sure, um, let me reach out to claims and see how we would handle that because yes, this, this should have gone to [PII]. Um, hold on one moment, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And before I put you on hold, just in case they ask, what's your sweet letter?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Well, we're a facility with a hospital that has several doctor's offices in it. But who's Suite A over there? That's not Doctor [PII]'s office, is it? But we're not a mercy clinic anywhere in this hospital, correct? That's what we're thinking, well, she said they're thinking it should have gone to [PII].
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] Yeah, cause everything on the.
[CUSTOMER][NEUTRAL] We don't really have, I mean, we've got different docs, we've got a couple. We've got a hospital side, and then we've got a doctor's side. We're just a small rural clinic. So we have an ER department and, and an in uh inpatient, but on the other side, we have some nurse, nurse practitioners and some doctors and their offices where you go see them may say [PII] or [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, but they're still not called Mercy Clinic East Community.
[AGENT][NEUTRAL] OK, so let me.
[CUSTOMER][NEGATIVE] So I wonder if somebody was making this check out to [PII] and just accidentally put the wrong address down maybe because actually I don't even know why the post office would have even delivered it.
[CUSTOMER][NEUTRAL] Because we're not, unless they just strictly go by the address, which in that case, this is our address.
[AGENT][NEUTRAL] Right, that's what I'm saying. So, that's what I'm trying to make sure, so I know what to say when I get the claim. So, the [PII] is Madison's correct address as well.
[CUSTOMER][NEUTRAL] Yes, Madison Medical Center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Because that's what, that's the address that came over on the claim form, but it says [PII], but the check doesn't say anything about [PII], it just has your address.
[CUSTOMER][NEUTRAL] Correct. I don't see anywhere where it says Madison Medical Center. It just says Mercy Clinic East Community.
[AGENT][NEUTRAL] OK, I got it.
[AGENT][NEUTRAL] So he, OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And it says provider of service up there on the, the stub it's got the dates of service, the patient account number, their account number probably and then Mercy Clinic is the provider of service.
[CUSTOMER][POSITIVE] And it's got the procedural code numbers and all that good stuff and the checks for $46 so.
[CUSTOMER][NEUTRAL] I don't see Madison on here anywhere.
[AGENT][NEUTRAL] OK, I'm gonna check with claims. Do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][POSITIVE] Good afternoon. 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?
[CUSTOMER][NEUTRAL] I'm fine thanks how are you?
[AGENT][NEUTRAL] I'm doing good. I have a provider um on the other line. They received a claim check. It's the right address, but the wrong provider name. Can you look at this with me? Um, she's asking if
[AGENT][NEUTRAL] If they need to send the check back or if this is correct, um, you mind helping me?
[CUSTOMER][NEUTRAL] Uh, yes, what's the policy number?
[AGENT][NEUTRAL] It's 203-205-4.
[CUSTOMER][NEUTRAL] And the name of the insured?
[AGENT][NEUTRAL] Is [PII]?
[CUSTOMER][NEUTRAL] OK, OK, give me that policy number one more time.
[AGENT][NEUTRAL] Mhm. 20 wait, I'm sorry, that's the check number. My apologies, 650641.
[CUSTOMER][NEUTRAL] OK, and what was the um.
[CUSTOMER][NEUTRAL] The claim number?
[AGENT][NEUTRAL] It's 3573469.
[CUSTOMER][NEUTRAL] OK, give me just a second, and they're saying that the check was mailed to the wrong provider?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So, right, so who I'm speaking with is from Madison Medical Center.
[AGENT][NEUTRAL] The check is for Mercy Clinic East.
[AGENT][NEUTRAL] She said that they they have the same address as the [PII].
[AGENT][NEUTRAL] And they have this person as a patient, but they're medicine and not mercy. So I looked up the docs in on base to see where the claim came from and that's the address. We sent it to what we got.
[CUSTOMER][NEUTRAL] Yes, uh, I mean, I see the address that we have in line and match it with on the claim. And so she's saying they have the exact same address at the Mercy Clinic East?
[AGENT][NEUTRAL] Yeah, and I asked, I said, so, so what's your sweet letter? and she said, well, we don't have one. We have a bunch, it's a bunch of different doctors in here, so nobody, they may tell you suit A, but no, nobody puts that in the address. So I'm like,
[AGENT][NEUTRAL] Well, that's on the form. I I don't. Should I tell her to send it back?
[CUSTOMER][NEUTRAL] So they're, are they the same building as Mercy Clinic East?
[AGENT][NEUTRAL] Yeah, it sounds like they, yeah, it sounds like they're all in the same.
[AGENT][NEUTRAL] Building, but she says she doesn't.
[CUSTOMER][NEUTRAL] Are, are they not able to stick in the chest?
[AGENT][NEUTRAL] She said she doesn't know what [PII] is because I'm like, I'm saying, so are they in the building with you? and she said, well, we're all [PII], it's like we're attached to a hospital, we don't know what [PII] is and I'm like,
[CUSTOMER][NEUTRAL] I guess
[AGENT][NEUTRAL] OK. So, I, I, I don't know.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Sounds like it's like a, it's doctors, you know, like, like an outpatient facility attached to the hospital. That's how she explained it.
[AGENT][NEUTRAL] So she doesn't know if she said everyone around her is [PII], but she doesn't know anything of [PII].
[CUSTOMER][NEUTRAL] OK, so what I guess we would do is just um if you can, you can let him know to send back the check.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and then we would just have to contact this provider and be able to basically I don't like get a different address or reference information, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that, that's the only thing I can think of doing if they, if they have no idea who [PII] is.
[CUSTOMER][NEUTRAL] I mean because that's what's on this bill so we would just have to um just we review that and just reach back out to them.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Well, I will tell her to send it back. Thank you.
[CUSTOMER][POSITIVE] Oh, sure, you're welcome.
[AGENT][NEUTRAL] All right, bye bye.
[CUSTOMER][POSITIVE] Thank bye bye.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] All right, thank you so much for holding. I apologize for that wait. Um, so claims is advising to um send the check back to us and we'll go ahead and do some more researching on our end.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and I've got it, is it the [PII]?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and do you want me to put anybody's attention on it? I just put a little note in there. I'm gonna wrap the check up and just I've got on here this is not our check. We are Madison Medical Center with that correct address, and I just thought we're not Mercy Clinic, so I didn't know if you needed anybody's name on it or.
[AGENT][NEUTRAL] Um, no, it's just that, that, um, fax, I'm sorry, fax, that PO box is going to the claims department, so no, you don't have to put anybody specific.
[CUSTOMER][NEUTRAL] OK, all right, I'll get it to that PO box number in [PII].
[AGENT][NEUTRAL] Alright, [PII], well, was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] No, that'll do me.
[AGENT][POSITIVE] Alright, well, thanks so much for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] You too, um, thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.