AccountId: 011433970860
ContactId: 8cf1a339-75c6-4afa-ad05-6ab07dabc9a9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 903780 ms
Total Talk Time (AGENT): 316979 ms
Total Talk Time (CUSTOMER): 229903 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/2025/02/19/8cf1a339-75c6-4afa-ad05-6ab07dabc9a9_20250219T16:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, I'm calling from the provider's office regarding claim status.
[AGENT][NEUTRAL] OK, I'm sorry it's a bit difficult to hear you um did you say claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] 02282219
[AGENT][NEUTRAL] OK, thank you and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII], the last name is [PII] [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that [PII]. Uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Um, the first date of service is [PII] for 300.
[AGENT][NEUTRAL] OK, that was [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] I'm sorry [PII], what was the name of the provider's office that you're with?
[CUSTOMER][NEUTRAL] Um, it should be listed as
[CUSTOMER][NEUTRAL] Um, Highlands therapy.
[AGENT][NEUTRAL] Do you have that tax ID by chance?
[CUSTOMER][NEUTRAL] Um, the tax ID is [PII].
[AGENT][POSITIVE] OK, thank you. I do believe I've found it. Let's see.
[CUSTOMER][NEUTRAL] So I've got several claims that we've billed you guys obviously a secondary and we haven't received anything and it looks like maybe some of them are saying that you need information, so I don't know what.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure I could take a look at that. Let me just verify that this is correct.
[AGENT][NEUTRAL] OK, I do have one. It looks like, um, what was that remaining balance after uh major medical pay Denise for this one?
[CUSTOMER][NEUTRAL] $30
[AGENT][NEUTRAL] OK, so we did pay that benefit for this claim, um, does that procedure code 97161?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, there's, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, yes, so we did pay that benefit give me just a moment I'll get that uh claim number and that check information for you.
[AGENT][NEUTRAL] OK, did you need that claim number?
[CUSTOMER][NEUTRAL] Um, I don't know necessarily need the claim number, but I just need, um,
[CUSTOMER][NEUTRAL] The payment information because we don't have the payment.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] It looks like that was this check was just issued [PII].
[CUSTOMER][NEUTRAL] Oh,
[AGENT][NEUTRAL] So and I do have that check number if you need that.
[CUSTOMER][NEUTRAL] So let me do this hold on um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So 4:16 paid, and what, when did you say it paid?
[AGENT][NEUTRAL] Uh, the check was issued [PII].
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] All right, go ahead.
[AGENT][NEUTRAL] Sure, it's 202-468-9.
[CUSTOMER][NEUTRAL] It was it a paper check?
[AGENT][NEUTRAL] Yes, uh, for $30.
[CUSTOMER][NEUTRAL] Oh, it was only 30.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, and what did you, was, is it cash? Do you see where it was sent to?
[AGENT][NEUTRAL] No, I am showing that it is still, um, it has not yet cleared so after once it reaches a 30 day mark after we had issued that then we can void it and reissue. I can verify the address that we sent it to though whenever you're ready.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][POSITIVE] Yes, that would, that would be good, yeah.
[AGENT][NEUTRAL] OK, so that was uh [PII], is that correct?
[CUSTOMER][NEUTRAL] Alright, yeah, that's, yeah, that's, yep, that's our lock box that works um.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEGATIVE] Very possible it just could have gotten delayed um but that's what you know once it reaches that 30 day mark if y'all haven't gotten it yet, um, then we can get that voided and reissued.
[CUSTOMER][NEUTRAL] All right. Um,
[CUSTOMER][NEUTRAL] I'm just looking here, this one is 4:23.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So it's 4:23. Let me just look here. I had myself organized, but I'm now I'm looking where, so 4:23.
[CUSTOMER][POSITIVE] OK, so 423 is paid. I don't have to worry about that, um.
[CUSTOMER][NEUTRAL] OK, what about um 418, 2024?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 170.
[AGENT][NEUTRAL] That was 170.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] OK, and it looks like for this one we also paid a benefit of $30 let's see.
[CUSTOMER][NEUTRAL] And when was that paid?
[AGENT][NEUTRAL] Give me just a moment let me get that.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So 4:18.
[AGENT][NEUTRAL] OK, so this check was also issued [PII], and I've got that check number as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It is 202-4682.
[CUSTOMER][NEUTRAL] Alright, what about data service 425 2024 for 240?
[AGENT][NEUTRAL] 4,254,240. Give me just a moment.
[AGENT][NEUTRAL] OK, and this one is also showing we paid a benefit of $30.
[AGENT][NEUTRAL] See
[AGENT][NEUTRAL] OK, and this one was also issued uh [PII].
[CUSTOMER][NEUTRAL] All right, and that check number?
[AGENT][NEUTRAL] 2024684
[CUSTOMER][NEUTRAL] All right, um.
[CUSTOMER][NEUTRAL] 5:14, it looks like we have the money for 5:14. What about um 4:30?
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] For 1:30.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] So 5:14, you guys didn't pay, so that maybe that's OK.
[CUSTOMER][NEUTRAL] 5
[AGENT][NEUTRAL] OK, so for this one, we also pay the benefit of $30.
[AGENT][NEUTRAL] And it was also issued [PII].
[AGENT][NEUTRAL] And that check number that is 2024681.
[CUSTOMER][NEUTRAL] All right, um.
[CUSTOMER][NEUTRAL] Looking to make sure, so 423 is already posted so we have that money and then for.
[CUSTOMER][NEUTRAL] 910 it looks like there's nobody paid. OK, what about 52-2024?
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] 200.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Of that one we also paid a benefit of $30. I get that.
[AGENT][NEUTRAL] Check number.
[CUSTOMER][NEUTRAL] That's weird. 127 and it's not in it because that's our lockbox address like that should be there. That's kind of weird.
[AGENT][NEUTRAL] It does look like a lot of these sent at once, um, and I'm not quite sure now that's [PII]. I don't know how bad y'all have been hit with the weather, but I know that's definitely made an impact around here.
[CUSTOMER][NEUTRAL] Yeah, I don't know. I'm in [PII], so I don't even know.
[AGENT][NEUTRAL] Oh, so we're, I'm in [PII], so, OK, um, so this one, yes, that benefit of $30 it was also issued [PII], um, that check number is 2024683.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Alright, what about 57 for 200?
[AGENT][NEUTRAL] OK, and that looks like the same.
[AGENT][NEUTRAL] $30.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] OK, uh, that one was also issued [PII], um, check number is [PII].
[CUSTOMER][NEUTRAL] 686. OK. What about 559?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Excuse me.
[AGENT][POSITIVE] You're OK.
[CUSTOMER][NEUTRAL] For for 270.
[AGENT][NEUTRAL] OK, uh, this one was the same. We also paid that benefit of $30 check was issued [PII] and that check number is 2024685.
[CUSTOMER][NEUTRAL] All right, what about 5 5:14 for 270?
[AGENT][NEUTRAL] OK, that one we also paid that benefit of $30. It was also issued [PII]. That check number is 2024692.
[CUSTOMER][NEUTRAL] Alright, and then I have 910, 2024 for 3:30.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Was that from a different provider by chance, [PII]?
[CUSTOMER][NEUTRAL] Um, so are we looking at 9:10 would have been.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] You know like 1.
[CUSTOMER][NEUTRAL] Nope, everything's the same.
[AGENT][NEUTRAL] OK, I do have a couple of claims from that date of service and one looks identical or we paid a benefit of $30 but it is citing it's from a different provider with a different tax ID.
[CUSTOMER][NEUTRAL] Would the tax ID be like [PII]?
[AGENT][NEUTRAL] Yes ma'am, that's it. OK.
[CUSTOMER][NEUTRAL] That's, that's us.
[AGENT][NEUTRAL] Alright, let's see.
[CUSTOMER][NEUTRAL] So then that one did pay the 30.
[AGENT][NEUTRAL] Yes, and give me just a minute, let me get that.
[AGENT][NEUTRAL] OK, so yes, that one paid the 30. It was also issued [PII]. That check number was 2024688.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] I think that might be it.
[CUSTOMER][NEUTRAL] So we just did [PII].
[CUSTOMER][NEUTRAL] OK, now let me ask you this is like the primary denied for whatever reason, is that something you guys would consider to pick up or you only pick up like what what?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Right, so this plan is very dependent on the primary insurance, so if they don't pay anything, this policy cannot.
[CUSTOMER][NEUTRAL] OK, yeah, basically that's what I was asking you, but I guess I didn't word it right, but yep, um, alright, I guess that's it. Do you have a reference number?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much.
[AGENT][POSITIVE] Alright, yep, thanks for calling API. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye bye