AccountId: 011433970860
ContactId: c32faaf9-b0ae-4ee8-8ce9-6549d30b935d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 438790 ms
Total Talk Time (AGENT): 196513 ms
Total Talk Time (CUSTOMER): 151865 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/c32faaf9-b0ae-4ee8-8ce9-6549d30b935d_20250416T14:51_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Calling American Public Life, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling um regarding a claim that my medical provider sent to APL um and the check was paid to the medical provider on [PII], but apparently it got lost in the mail. It's, they haven't received it, so I was wondering if you can send a new one.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, OK. I can take a look at that for you. [PII], could I get a callback number for you?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you. And what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] 01813054
[AGENT][NEUTRAL] 54
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what is the uh date of uh service in question?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And I have a check number here that someone provided from APL. Um, it just hasn't been passed since February that it was sent out to the medical provider.
[AGENT][NEUTRAL] OK. And um,
[AGENT][NEUTRAL] What is the total amount of the payment? Do you show that?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] $713.80.
[AGENT][NEUTRAL] OK, do you have a claim number? I have a lot of claims on this date. Oh, I see it. I see it here. I'm sorry.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] 71,380.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And that's check number 2022004.
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and the mailing address, uh, what is the correct mailing address the check should have gone to?
[CUSTOMER][NEUTRAL] Uh, so, Ames, um, Association, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, just wanted to make sure.
[AGENT][NEUTRAL] OK, and so we need to do a um.
[AGENT][NEUTRAL] Void and reissue on this check on this payment.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] Yes, please, and I also have another amount that APL has not paid, they told me.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It's $627.80.
[AGENT][NEUTRAL] For this particular claim or a different data service?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Same date of service.
[CUSTOMER][NEUTRAL] So they told me it's in the same uh claim number.
[AGENT][NEUTRAL] OK, so it's for for data service [PII].
[AGENT][NEUTRAL] And let me see.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Do you have a claim number that was not uh paid?
[CUSTOMER][NEUTRAL] Um, I don't have a claim number, but it's under the same account number. Do you need?
[CUSTOMER][NEUTRAL] The account number?
[AGENT][NEUTRAL] No, I would need uh at least the data service and the total amount billed.
[AGENT][NEUTRAL] And which payment is still there?
[CUSTOMER][NEUTRAL] Yeah, the total amount.
[CUSTOMER][NEUTRAL] It's $627.80.
[AGENT][NEUTRAL] 62,780,620.
[AGENT][NEUTRAL] And it's for the same provider?
[CUSTOMER][NEUTRAL] Yeah, same one.
[AGENT][NEUTRAL] OK. I do not show we've received a claim for that data service and amount from your provider.
[CUSTOMER][NEUTRAL] So they would need to submit another claim for the same.
[AGENT][NEUTRAL] They would need to
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, this is a different claim, um.
[AGENT][NEUTRAL] They they would definitely need to send.
[AGENT][NEUTRAL] Uh, send the claim. It, it doesn't show we received the charge. Um, we've only received, uh, the particular one in question that's the total bill is $2,702.
[CUSTOMER][NEUTRAL] 2007.
[AGENT][NEUTRAL] Which is the one you are uh waiting for the check to be reissued, but we don't have any other claims from the provider so um there is no timely filing they can't submit the claim for payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. All right. I'll let them know what they told me was that 11 amount was for the hospital bill and the other one was for the doctor. So that's why there were two different, um, two different, uh, bills that came to me with these different amounts, um, but then again, they only sent one to you, so then I'll call them up.
[AGENT][NEUTRAL] So it's not
[AGENT][NEUTRAL] OK, so it's not for the anesthesiologist. It would be, is the, the claim you're questioning and payment that you haven't received, is it for the anesthesiologist or a different provider?
[CUSTOMER][NEUTRAL] I think it's for the anesthesiologist. It says anesthesia service doctor.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then it says commercial adjustments and applied to deductible was the 62,780.
[AGENT][NEUTRAL] OK, yeah, we have not received that one, so you can uh have that resubmitted for payment.
[CUSTOMER][POSITIVE] OK. All right, got it. Thank you so much.
[AGENT][NEUTRAL] And I will go ahead and put in a request for a void and reissue on check [PII].
[CUSTOMER][NEUTRAL] OK, do you have a new check number by any chance, or you don't have that yet?
[AGENT][NEUTRAL] No, not until the claim is, we have to void the check that hasn't been cashed because we still show it open, so it has to be voided first, then I will um.
[AGENT][NEUTRAL] Um, do a new claim and then once it's paid the check number you'll get the, you know, there's a check number, but the following day. So what you can possibly do is, what is today? Wednesday, um, you could probably call back by Friday.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, to get the the new check number.
[CUSTOMER][POSITIVE] OK, got it. I will. Thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] That's it. Thank you. Have a nice day.
[AGENT][POSITIVE] You have a wonderful day yourself and thank you for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Thanks bye.