AccountId: 011433970860
ContactId: c0ef5eb9-d76b-422e-9e39-5ac34b48ad4b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 568340 ms
Total Talk Time (AGENT): 272705 ms
Total Talk Time (CUSTOMER): 134318 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/2025/01/15/c0ef5eb9-d76b-422e-9e39-5ac34b48ad4b_20250115T20:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] calling from provider's office for the medical claim status.
[AGENT][NEUTRAL] Sure, [PII], I can help you with the claim status. May I please have your callback number?
[CUSTOMER][NEUTRAL] [PII]. By the way, could you please uh spell out your name for me once again?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Last initial [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], can I have the name of the provider or facility you're calling from, please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's from uh Solantic of South Florida LLC.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the uh policy number or member ID please?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] It's 20.
[CUSTOMER][NEUTRAL] 29
[CUSTOMER][NEUTRAL] 80
[CUSTOMER][NEUTRAL] 29
[CUSTOMER][NEUTRAL] M for Mary,
[CUSTOMER][NEUTRAL] L for Lima, 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] If that policy number did not pull up. Can I have you repeat that? 20298029?
[CUSTOMER][NEUTRAL] Mhm. Correct. ML 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, that policy number did not come up in my system. Can you please um give me the patience.
[AGENT][NEUTRAL] Last name or do you have a social security number to search with or if not, what's the patient's last name, please?
[CUSTOMER][NEUTRAL] No, I
[CUSTOMER][NEUTRAL] Yeah, patient's last name.
[CUSTOMER][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the first name?
[CUSTOMER][NEUTRAL] First name, [PII]
[AGENT][NEUTRAL] And what's the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, just give me one moment to search please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And do you have a mailing address for?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, you've been
[CUSTOMER][NEUTRAL] The PO box, uh, I think.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, the patient address, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] is the ZIP code.
[AGENT][NEUTRAL] Thank you and go ahead with the data service and the amount on the claim please, [PII].
[AGENT][POSITIVE] Thank you for verifying that.
[CUSTOMER][NEUTRAL] Date of, uh, before, yeah, before that, uh, is, what is the member ID number of this patient?
[AGENT][NEUTRAL] It should be
[AGENT][NEUTRAL] 02.
[AGENT][NEUTRAL] 29.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So it's 0229.
[AGENT][NEUTRAL] 8029.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] 02298029
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I think we just either transpose the number or we've added one too many numbers one too many zeros.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK. So, yes, the date of service, it's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the amount on the claim?
[CUSTOMER][NEUTRAL] $270 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now it looks like we got the claim more than once, so just bear with me while I research that information.
[CUSTOMER][NEUTRAL] Uh, before that, I'll confirm you the recent one we have built on [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, you can check with that basis.
[AGENT][NEUTRAL] OK I'm gonna pull the claim image up, so just bear with me for one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, $270 for 626 of 2024.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I do show that um the claim was first received, we requested the explanation of benefits from the primary insurance. We received that um explanation from the primary insurance.
[AGENT][NEUTRAL] And that was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was processed on [PII].
[AGENT][NEUTRAL] That claim number is 34.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 95.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] 278.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we made a benefit payment of $50.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Check number is 18.
[AGENT][NEUTRAL] 1869.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 169 again for $50.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The payee Solantic of South Florida LLC.
[AGENT][NEUTRAL] Again, 186-9169 for $50. I showed the um I show the.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, last update was the check is still outstanding as of [PII], so you didn't receive this check?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, and I'm gonna verify the address [PII] in [PII].
[CUSTOMER][NEUTRAL] Yes, correct. ZIP code [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yep, [PII] the payee Selantic of South Florida LLC.
[AGENT][NEUTRAL] So you do not
[CUSTOMER][NEUTRAL] What was the payment date?
[AGENT][NEUTRAL] Um, the, the issue date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it does not, it does not appear it's been cash, so what I need to do um is I'll have to send an internal inquiry, um, just to make sure the check is not been cleared and it will be voided and a new check will be issued.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can allow, uh, if you can allow us the 33 days uh to turn around time to get this processed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you have any other questions, [PII]?
[CUSTOMER][NEUTRAL] No, actually.
[AGENT][NEUTRAL] OK, because it does look like we received the claim, uh, on that October date, um, as you had said we received it [PII] processed on [PII], and we denied it as duplicate, um, and then the same we received it again it looks like for uh.
[AGENT][NEUTRAL] November and it was also denied as a duplicate. So what we're gonna do, like I said is I'll send that inquiry uh internally and they'll just search for that check, make sure it's not been cashed, it will get voided and a new check will be reissued.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if there's any questions I can contact you at that number you provided me [PII].
[CUSTOMER][POSITIVE] Yeah, you can.
[AGENT][NEUTRAL] OK, alright, great [PII] did you have any other questions?
[CUSTOMER][NEUTRAL] No, just go ahead and provide me the call reference number.
[AGENT][NEUTRAL] Sure, that call reference number, [PII] is my name and today's date. Again, it's [PII] my last initial L like love in today's date.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome thank you for calling APL. I hope you have a great rest of your day, and we'll get this taken care of and reprocessed for you.
[CUSTOMER][POSITIVE] Yeah, thank you.
[AGENT][NEUTRAL] Alright bye bye.
[CUSTOMER][NEUTRAL] Bye.