AccountId: 011433970860
ContactId: c9b8101a-dd63-45cd-8c4e-4b6c44c787c7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1271369 ms
Total Talk Time (AGENT): 324447 ms
Total Talk Time (CUSTOMER): 536607 ms
Interruptions: 5
Overall Sentiment: AGENT=-0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/c9b8101a-dd63-45cd-8c4e-4b6c44c787c7_20250416T13:39_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I am calling from a doctor's office, and I would like to talk to you about 4 claims for 1 patient.
[AGENT][NEUTRAL] OK, [PII], do you have a phone number I can get in case we get disconnected I can call you back.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] I do. It is 01742617.
[AGENT][NEUTRAL] Thank you. Hold on one moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] What was the patient's name?
[CUSTOMER][NEUTRAL] Her name is [PII].
[AGENT][NEUTRAL] And her date of birth.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII], and you had questions on claims?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, um, I talked to [PII] about this last month and uh following up, um, can you first look at data service [PII]?
[AGENT][NEUTRAL] OK. Yes, ma'am. I can look that up for you. Hold on one moment.
[CUSTOMER][POSITIVE] Thank you, thank you.
[AGENT][NEUTRAL] And the total charge for that.
[CUSTOMER][NEUTRAL] $293.
[AGENT][NEUTRAL] 293.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that was for 87, or 24?
[CUSTOMER][NEUTRAL] Yes, uh, do you need, and, you know what, you may see $125. There were two line items, but her primary UnitedHealthcare paid for 100%, yeah, $125. Um, can you tell me why you did not pay the $25 remainder co-pay?
[AGENT][NEUTRAL] Yes, that's what I see.
[AGENT][NEUTRAL] Office visits are not covered under this policy.
[CUSTOMER][NEGATIVE] Office visits not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you now look at data service [PII].
[AGENT][NEUTRAL] And what, what's the procedure code?
[CUSTOMER][NEUTRAL] 76816.
[AGENT][NEUTRAL] And it was just one on there.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] Now I do know you have been trying to pay us 12,570 I your company I think has issues with our company um you're mailing the checks to the actual clinic.
[CUSTOMER][NEUTRAL] Um, and so when I talked to [PII] last month she said she's going to void the original check and then have a new one reissued. Can you tell me the status of that situation? Oh, OK, sweet. Um, have you mailed out the new one yet?
[AGENT][NEUTRAL] She did.
[AGENT][NEUTRAL] Hold on just a moment. I'll check and see when it was mailed.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] It was mailed on [PII].
[CUSTOMER][NEUTRAL] OK, and did that go to the clinic's address in [PII]?
[AGENT][NEUTRAL] Hold on just a second, I can look at it for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEGATIVE] Yes, we've had a lot of problems with you all's checks.
[CUSTOMER][NEUTRAL] I know, I know.
[AGENT][NEGATIVE] Just about every one of them has to be void and reissue.
[CUSTOMER][NEGATIVE] Uh, it's a pain and I've asked the manager at this office. I said, you know, when your office receives these checks, do you just mail them on to our lock box and they said they do, but I don't think they do.
[AGENT][NEUTRAL] OK, this
[CUSTOMER][NEUTRAL] Because they come back to you.
[AGENT][NEUTRAL] Check went to [PII].
[CUSTOMER][NEUTRAL] Yeah, you know what we talked about that before and um I have no idea where that is. I sent a W-9 because our lock box where all insurances usually mail a check is in [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I had told her I, I don't know this 505-59 because when you look at the actual claim, the 1500, that address isn't on there so I don't know.
[CUSTOMER][NEUTRAL] Where you're getting that and I think that's maybe the issue because if you do take a look at our claim our 1500.
[CUSTOMER][NEUTRAL] Do you see that address on there? I do not.
[AGENT][NEUTRAL] Hold on just a second, I'm gonna pull up the claim.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, hold on just a second it looks like.
[AGENT][NEUTRAL] Hold on just a moment. I had to pull up the original one.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, on the original claim, it's [PII].
[CUSTOMER][NEUTRAL] Yes, and that is the actual uh doctor's office. So do you know why or where they came up with this [PII]?
[AGENT][NEUTRAL] That I do not know.
[CUSTOMER][NEUTRAL] OK, um, so I mean we have an issue here because like I said I, I don't know where your checks are going. I think maybe that's the issue.
[CUSTOMER][NEUTRAL] What, what can we do to get this fixed?
[AGENT][NEUTRAL] The only thing we can do is start voiding all these checks and you have to send in a new claim with all the correct address that you all want to go to in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, well, they say that the doctor's office that you know the [PII] address, that's the way it is, um, so I mean that makes sense if you're sending it to [PII] and the office says we're not receiving these, um, how is that our mistake if if we don't even know what [PII] is?
[AGENT][NEUTRAL] Um, I can.
[AGENT][NEUTRAL] I'm not sure. I'll have to get with my supervisor and ask her, but whatever's in [PII], that's where we're gonna send the check most of the time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, but yeah, but you just, but you just verified that.
[AGENT][NEGATIVE] Right, that it's going to the wrong one.
[CUSTOMER][NEUTRAL] [PII] is in [PII].
[CUSTOMER][NEUTRAL] Yeah, so I mean.
[CUSTOMER][NEUTRAL] I don't think that's our fault, so, um, can I talk to the supervisor or can she call me back?
[AGENT][NEUTRAL] She can. Um, what's your, I got your number [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, yes, and then, um, can we check on two more to see if it's the same situation? Like I said, we talked, I had talked to [PII] about this, uh, in March, um, and she had mentioned the same thing about that PO box number, um, and I said no, no, no, no, but.
[CUSTOMER][NEUTRAL] You know something's getting hung up.
[AGENT][NEGATIVE] I don't know why they issued it to that PO box. They should have issued it to that [PII] again.
[CUSTOMER][NEUTRAL] Um, OK, can you look.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, yeah, um, can you uh can you.
[AGENT][NEUTRAL] So if we issue it to the street addresses, you all will get it?
[CUSTOMER][NEUTRAL] Yeah, because that's the doctor's office. That's where all the patients go to the doctor's office and they told the office manager about this because I'm like, are you getting these checks? and she said no. And I said, Well, if you do, you know, to mail them to our lockbox in [PII]. She goes, yeah, I do other people. So but that makes sense. Like I said, they're going to some address we have no idea.
[AGENT][NEGATIVE] The wrong address, right.
[CUSTOMER][NEUTRAL] Um, yeah, so can you look at data service [PII]?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Let me see where this check went. It was paid. Let me see what address it went to.
[AGENT][NEUTRAL] Now this one went to that [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, now I know um the original check I think was mailed back in [PII] um something happened, it didn't get here, so when I talked to [PII] last month, she was going to issue another one and you're telling me that the one from last month was sent to the [PII] address.
[AGENT][NEUTRAL] But no, it has not been reissued. Let me see when it was paid the original. Hold on just a second.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] [PII]. It's not been voided or reissued or anything because it went to the correct address.
[AGENT][NEUTRAL] Let's see when it was issued.
[CUSTOMER][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, it was issued [PII].
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] I mean we haven't received it so can that one be?
[AGENT][NEUTRAL] It has not
[AGENT][NEUTRAL] Been voided and reissued.
[CUSTOMER][NEUTRAL] OK, alright, can that be voided and reissued to the [PII] address doctor's office?
[AGENT][NEUTRAL] Right, I think the problem is also, even though we reissuing them these to this [PII], we're still getting them returned a lot.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But if it's returned to you.
[CUSTOMER][NEUTRAL] Um, does it get voided right away or not?
[AGENT][NEGATIVE] If it's returned.
[AGENT][NEUTRAL] And it was sent to the right address. Usually we call and see what the correct address is.
[AGENT][NEUTRAL] But see, legally we can't reissue these checks to a different address unless we have a corrected claim with the address that you all want to go to.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right, and, and you know what I mean it can it can you void it and just reissue it back to the doctor's office?
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, and I wanna call the doctor's office, find out who gets the mail and tell him what to do.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Now if you all want to go to that lock box, all they would have to do is put it in box 33.
[AGENT][NEUTRAL] On all claims.
[CUSTOMER][NEUTRAL] Right, and I've talked to our registration, and they can't do that. I'm not for sure why, so I'm kind of stuck in the middle. You're stuck in the middle, so we just need to get around it. So yeah, if you could just void the original one from November, have a new one reissued, and just send it back to the the doctor's office address that's in [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'll get that one voided and reissued for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But then yeah still ask your.
[CUSTOMER][NEUTRAL] Manage supervisor though.
[CUSTOMER][NEGATIVE] Don't send it to that [PII] something.
[AGENT][NEUTRAL] Right, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And then when you're ready I just have uh one more.
[AGENT][NEUTRAL] OK, and what's the next one?
[CUSTOMER][NEUTRAL] Um, the next one is date [PII].
[CUSTOMER][NEUTRAL] For $174.
[AGENT][NEUTRAL] Was it 2 procedure codes on that one?
[CUSTOMER][NEUTRAL] Uh, no, it was procedure code 76805.
[AGENT][NEUTRAL] OK, I see it's a different provider.
[CUSTOMER][NEUTRAL] And it looks like um.
[AGENT][NEUTRAL] Is it 26 or TC?
[CUSTOMER][NEUTRAL] You would have
[AGENT][NEUTRAL] For the modifier? TC OK.
[CUSTOMER][NEUTRAL] It's a TC
[CUSTOMER][NEUTRAL] Yeah, and you had paid 9920.
[AGENT][NEUTRAL] 2
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Back in August
[CUSTOMER][NEUTRAL] And then [PII] last month said she would have a new check come out.
[AGENT][NEGATIVE] She looks like she did not do this one either.
[AGENT][NEUTRAL] Let's see, hold on, let me see where it went.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It went to the correct address as well, the [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Right, OK, and when was that reissued?
[AGENT][NEGATIVE] It was not reissued.
[CUSTOMER][NEUTRAL] Oh, it was not OK so you're talking about the one from August, yeah, OK.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] It has not.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] 151.
[AGENT][NEUTRAL] It was issued 825-23.
[CUSTOMER][NEUTRAL] Yeah, that's what, uh, [PII] had said also.
[AGENT][NEUTRAL] But it has not been voided and reissued.
[CUSTOMER][NEUTRAL] OK, can that can that be voided and reissued to the address that's in [PII]?
[AGENT][NEUTRAL] Right, yes, ma'am.
[CUSTOMER][POSITIVE] OK great thanks.
[AGENT][NEGATIVE] But we need to do something because all these checks are coming back even though we're sending them to the correct address. Y'all are not getting them.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah and you know I don't know who I'm gonna like I said I'm gonna call the doctor's office and find out who gets the mail you know and tell him.
[CUSTOMER][NEUTRAL] What to do, you know, back in 23, I don't know, maybe it was somebody else who worked there. I have no idea um but yeah, if you could just skip those and then, you know.
[CUSTOMER][NEGATIVE] Fix or talk to your supervisor about that first one that we talked about.
[AGENT][NEUTRAL] OK, I'll get those two voided.
[CUSTOMER][NEUTRAL] Um, is there anything else you
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, is there a reference number for our call today?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date. That's [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK great OK and then you'll talk to the supervisor and hopefully reissue that to the doctor's office?
[AGENT][NEUTRAL] Yes, ma'am. What day of service was that? Let me go back and look at it. Let me see how long it's been.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] I think it was uh [PII].
[AGENT][NEUTRAL] When did
[AGENT][NEGATIVE] OK, it was just paid 10, so they may get that one, so we're not gonna reissue that one.
[CUSTOMER][NEUTRAL] Oh yeah it was.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I, I don't
[CUSTOMER][NEUTRAL] OK, but you know, like I said, I have worked.
[AGENT][NEUTRAL] Uh, for 30 days.
[CUSTOMER][NEUTRAL] OK, but remember though, I mean I've been here for 30 years. I have no idea what [PII] is.
[AGENT][NEGATIVE] Oh yeah, that was, that's the one that went to the wrong address.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, yeah. I'm sure she'll.
[CUSTOMER][NEUTRAL] Yeah, and that's what you were going to talk to her about.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, yeah, to see where where they come up with that because it's not anywhere on the claim.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] So OK great OK well thank you [PII] I appreciate your help, huh?
[AGENT][NEUTRAL] Uh, I, I don't have to talk to her about that one. I can just get it void and reissued, but would you like to talk to her about all these checks coming back?
[CUSTOMER][NEUTRAL] Um, no, because I talked to [PII] and I'm not.
[CUSTOMER][NEGATIVE] I'm not the go to person. I mean, I, I don't enter the address that goes in the 1500. I don't even know how to do that. I just call on denied and unpaid claims, so I'm, I'm not the right person.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I mean we do get some you know I mean I do have claims that are getting paid so you know I'm I'm not quite for sure.
[CUSTOMER][NEUTRAL] Why some are and some are not.
[AGENT][NEUTRAL] Right, because we get a lot but.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] For Mercy Clinic
[CUSTOMER][NEUTRAL] Yeah, because I'm looking at a.
[CUSTOMER][NEUTRAL] Yeah, I'm I'm looking at one.
[CUSTOMER][NEUTRAL] From I guess not from our doctor's office but maternal fetal medicine, um, and they received, um, they received, you know, your check and let me see where you mail that to.
[CUSTOMER][NEUTRAL] Yeah, you're mailing that to their office too so.
[CUSTOMER][NEUTRAL] But um yeah so yeah if you can just talk to your supervisor or I guess you can do it void and.
[CUSTOMER][POSITIVE] You know, so anyway, we talked about it we talked enough, so all right, thank you, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you for calling APO. You have a good day.
[CUSTOMER][NEUTRAL] Alright, goodbye. uh Sure you too bye bye.
[AGENT][NEUTRAL] Hm bye bye.