AccountId: 011433970860
ContactId: 95f7371a-5c1f-4e9e-9198-0597d9a66966
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 464350 ms
Total Talk Time (AGENT): 214675 ms
Total Talk Time (CUSTOMER): 84479 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/95f7371a-5c1f-4e9e-9198-0597d9a66966_20250217T15:33_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling ATL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh yes, this is uh [PII] with Mercy Clinic, and I was calling to uh check the status of a medical claim please.
[AGENT][NEUTRAL] OK, and my apologies, may I have your name again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you so much and your callback number if we're disconnected please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you [PII] and what is the policy number?
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] That is our payer ID.
[CUSTOMER][NEUTRAL] Oh
[AGENT][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] OK, well let me see here if they've got it on a different thing here um.
[CUSTOMER][NEUTRAL] OK, I'll try this 1 02554151.
[AGENT][POSITIVE] OK, yes, thank you, [PII] one moment.
[CUSTOMER][NEUTRAL] OK, mhm.
[AGENT][NEUTRAL] And verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you very much for the information, [PII], and again you're calling for claim status. Uh, would this be for a medical claim or a dental claim, please?
[CUSTOMER][NEUTRAL] A medical.
[AGENT][NEUTRAL] Medical claim. OK, thank you so much. Give me one moment. That was actually the dental policy number if you would just bear with me please, [PII], one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Now actually, uh of course provide that number to you when I find that for you.
[AGENT][NEUTRAL] OK, I was able to locate the medical policy number, so let me provide that to you when you're ready, please.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, it is 02554149.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you so much. Now what is that date of service and the total charge amount please?
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] [PII] $273.
[AGENT][POSITIVE] OK, thank you so much. [PII] $273 even one moment.
[AGENT][NEUTRAL] Can you verify that procedure code please?
[CUSTOMER][NEUTRAL] 99204.
[AGENT][NEUTRAL] Thank you, and it shows that the claim was received on [PII] and it was processed [PII], and we made a maximum payment in the amount of $50.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I have the both claim and check numbers if you need that as well.
[CUSTOMER][NEUTRAL] OK, that'd be fine.
[AGENT][NEUTRAL] OK, the claim number shows 352-678-87.
[CUSTOMER][NEUTRAL] They
[AGENT][NEUTRAL] It was a single paper check, check number 2,012,280.
[AGENT][NEUTRAL] And if you like I can check to see if that has cleared.
[CUSTOMER][POSITIVE] OK, yeah, that'd be great.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And also this K you're able to check claim status by visiting our secure portal at [PII], but if you would need a copy of this, you'll be, I can fax it over to you. Give me one second to check that check status for you.
[AGENT][NEUTRAL] OK, that was 2,012,280 and that check shows currently outstanding. It does not show that it has cleared the bank as of yet. With that being said, let me just verify that mailing address please with you.
[AGENT][NEUTRAL] One moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm almost there. I just have to wait for the image to populate.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you for your patience. OK, the check was mailed to Mercy Clinic Fort Smith Community.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, well.
[CUSTOMER][NEUTRAL] I don't know why the address is changed, but all of our, uh, payments go to our lockbox in [PII].
[CUSTOMER][NEGATIVE] So this check's probably gotten lost somewhere.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] OK, I can put a request in to have the check voided. However, the claim that was submitted in has this address on it both in the [PII] and [PII], um.
[CUSTOMER][NEUTRAL] Why?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] So we would need
[AGENT][NEUTRAL] An updated claim.
[AGENT][NEUTRAL] Um, that shows the correct mailing address.
[CUSTOMER][NEUTRAL] OK, all right.
[AGENT][NEUTRAL] Let's see here, give me one second, let me look at something else, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am, let's see here.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'll make note that you will send in a claim with an updated mailing address on it, um, because if once I send the request to have this claim, the check did not excuse me, voided, of course, and what the only claim that we have in our office or in in office is the mailing address of Mercy Clinics for Smith Community. So that's why we would need an updated claim with the correct billing address. I'm sorry about that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that's all right.
[CUSTOMER][POSITIVE] OK, I'll get it to the correct department to get it taken care of.
[AGENT][POSITIVE] OK, yes ma'am, I'm sorry about that. um, anything else I can help you with, Miss [PII]?
[CUSTOMER][POSITIVE] OK, that's all right.
[CUSTOMER][NEUTRAL] That's all.
[AGENT][POSITIVE] OK, well thank you so much for calling with the APL. Have a good day.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Goodbye.