AccountId: 011433970860
ContactId: c5d4d318-1528-4da9-b4c7-9e46fac1f348
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 774989 ms
Total Talk Time (AGENT): 332327 ms
Total Talk Time (CUSTOMER): 181249 ms
Interruptions: 3
Overall Sentiment: AGENT=0.9, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/c5d4d318-1528-4da9-b4c7-9e46fac1f348_20250113T21:48_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I am calling to check on a payment or a check. It looks like we requested to be reissued.
[AGENT][NEUTRAL] OK, [PII], so you said that you had requested a check be reissued because it was not received and you're wanting to follow up on that. Is that correct? Yes, ma'am. I can help you with that. And [PII], what is your callback number?
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And the policy number please for the member.
[CUSTOMER][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] You know, one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, like the plan's no longer active, so let me do this different way.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, OK, it is 02484149.
[AGENT][NEUTRAL] Say that one more time, please.
[CUSTOMER][NEUTRAL] 02484149
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK and [PII], any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Um, [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what is the data service [PII] and total bill amount that you're calling about?
[CUSTOMER][NEUTRAL] [PII], billed amount was $443.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give me just a moment to look at a couple of things.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the provider's name, please?
[CUSTOMER][NEUTRAL] Doctor [PII].
[AGENT][NEUTRAL] Mm. What, uh,
[AGENT][NEUTRAL] I just
[AGENT][NEUTRAL] What is the tax ID number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so I do see that this was, was reissued back in
[AGENT][NEUTRAL] Um, I'm sorry, the issue date was [PII]. This claim was, this check was issued to that same address and it is still showing as outstanding.
[CUSTOMER][NEUTRAL] I so.
[AGENT][NEUTRAL] But who did you say the provider is?
[CUSTOMER][NEUTRAL] Doctor [PII]
[AGENT][NEUTRAL] What's the price?
[AGENT][NEUTRAL] OK, give me a moment to log your account for both.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, we have a different provider's name on here.
[AGENT][NEUTRAL] It's the same tax ID but it is a different provider name.
[CUSTOMER][NEUTRAL] OK, but the billing provider would be Doctor [PII].
[AGENT][NEUTRAL] This claim, again, it was, this check was reissued.
[AGENT][POSITIVE] And it does still show that it is outstanding and it was mailed to that address that you gave me.
[CUSTOMER][NEUTRAL] OK, let's see. I'm gonna look at her chart. Was it under Doctor [PII]?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh, well.
[CUSTOMER][NEUTRAL] OK, so was the check made out to Doctor [PII]?
[AGENT][NEUTRAL] Yeah, well, it, it has V Y and then D O.
[CUSTOMER][NEUTRAL] Oh yes, yeah, um.
[AGENT][NEUTRAL] That's ever how you say that.
[CUSTOMER][NEUTRAL] Yeah, um, Doctor [PII], would you, OK, so why, I guess I'm trying to understand why if, yes, that was the treating provider, but in the billing provider box on the claim, it's Doctor [PII] cause he's our, he's the owner, owner of the practice.
[AGENT][NEUTRAL] But yes, it, uh-huh.
[CUSTOMER][NEUTRAL] Why is it being made out with the treating provider?
[AGENT][NEUTRAL] I mean look at
[AGENT][NEUTRAL] So what I can do, since this has been, um, this has been done more than once, I can I can try and transfer you to one of the examiners, [PII], who reviews this type of claim, um, to have them look at that with you since they were both issued the same way. Um, so give me just a moment though, my system is still trying to load a piece of information that I wanted to look at before I do connect you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But when I do transfer you, um, I will let them know the reason for your call.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] Before I release you to, to one of them. Oh, you're welcome, but my system is still.
[CUSTOMER][POSITIVE] OK, perfect, thank you.
[AGENT][NEUTRAL] Working on loading this last piece of information. It is, it's thinking it's had a long Monday.
[CUSTOMER][POSITIVE] Thinking, no problem.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] So yeah, it's take it.
[AGENT][NEUTRAL] OK, well maybe I can't maybe it's not gonna load it for me at all. OK, so what I'm gonna do is I'm just gonna go ahead and transfer you over.
[AGENT][NEUTRAL] Um, well, give, give me just one second, but before I transfer you, I wanted to have this one document where I could look at it for just a moment.
[CUSTOMER][POSITIVE] Yeah, no problem.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so yes, it's not gonna let me, it's not, it's not gonna load this for me. So, um, if you will give me just a moment then [PII], I will connect you, but before I do that, is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] Uh, no, this is my, uh, let me just double check, but I'm pretty sure this is my only one. Yeah, this is my only one for you.
[AGENT][POSITIVE] This is the only one? OK. All right then. Well, thank you so much for calling APL. I hope that you have a very nice evening and if you will give me one moment, I will get you connected over to uh one of the examiners.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, perfect. Thank you.
[AGENT][POSITIVE] You're welcome and thank you again for calling APL. I hope you have a nice evening.
[CUSTOMER][POSITIVE] Thanks you too bye now.
[AGENT][POSITIVE] Alright, thank you. Mhm, bye bye.
[CUSTOMER][NEUTRAL] Sing.
[CUSTOMER][NEUTRAL] Calling APL, my name is [PII]. How may I assist you today?
[AGENT][NEUTRAL] Well, hi, [PII]. It's [PII]. How are you?
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] I'm good, I'm good. So I have a call, the reason I'm transferring is, um, this is the provider's office and her name is [PII].
[AGENT][NEUTRAL] And the phone number is actually the one that you see on the sys on the screen is what she gave us a callback, but it's on policy number 248-4149 for [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Was [PII].
[AGENT][NEUTRAL] And it's regarding a check that's already been voided and reissued once to the correct address.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] But she's questioning why it was made out to who it was made out to Doctor Do.
[AGENT][NEGATIVE] He was the training, she said that's, and I can't pull it up and on base. I can't even look at this claim and on base. It told me I don't, I can't, it, it told me it's not gonna let me look at this. Let's put it like that. On base not being very nice to me at the moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But anyway, cause she says on the claim form, this doctor was like a treating doctor, but it should be made out. Anyway, she's saying that
[AGENT][NEUTRAL] Who it's made out to versus what is marked on the claim is not correct. The address is correct, but it should be made out to a different, to the provider that owns the practice is what she's saying.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and what, which claim number was that? Is the one ending in 355?
[AGENT][NEUTRAL] Yes, uh-huh, because that's the one that was reissued. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK alright one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah, I, they said I didn't have access to that. I was like, really? So I tried it again and said, I still didn't have that. I was like, OK.
[CUSTOMER][POSITIVE] Oh wow.
[AGENT][NEGATIVE] They stripped me on my rights and I didn't even realize it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, if they didn't want making it out to them, let me, let me do more things.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't even see any other practice listed under that tax ID in, in our system. OK. Well, that's what day I oh.
[AGENT][NEUTRAL] Other than that, Doctor [PII] or whatever.
[AGENT][NEUTRAL] I don't know. And I can't see what she's talking about on the claim itself, so.
[CUSTOMER][NEUTRAL] That's all that's.
[CUSTOMER][NEUTRAL] Put her 3 so I can let her know I'm gonna put that on the claim form.
[AGENT][NEUTRAL] I don't mind.
[AGENT][NEUTRAL] OK, well.
[CUSTOMER][NEUTRAL] So we put it on the check.
[AGENT][NEUTRAL] And and that that is still out there, so that's um
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I don't know, I mean, it was issued way back in November. So anyway, but.
[AGENT][POSITIVE] Are you ready to speak to Ms. [PII], Ms. [PII]? All right. Thank you so much and you have a nice evening, OK?
[CUSTOMER][POSITIVE] I'm ready. Put it through. I'm ready. Thank you so much.
[CUSTOMER][POSITIVE] You too thanks.
[AGENT][POSITIVE] Uh, thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye.