AccountId: 011433970860
ContactId: d03f579e-fb7a-45f7-88b8-61b5ef94566e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 780400 ms
Total Talk Time (AGENT): 294456 ms
Total Talk Time (CUSTOMER): 169498 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/d03f579e-fb7a-45f7-88b8-61b5ef94566e_20250523T20:49_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], my name is um [PII], and I'm trying to get um status on a, on a, on a pending claim.
[AGENT][NEUTRAL] OK, I can help you with the claim status. Are you the insured or you're calling with the provider's office?
[CUSTOMER][NEUTRAL] Provider's office.
[AGENT][NEUTRAL] All right. And may I have a good contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] Um, sure, it is um [PII].
[CUSTOMER][NEUTRAL] And the policy is 0184207.
[CUSTOMER][NEUTRAL] 0 ML 7.
[AGENT][NEUTRAL] Thank you. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill?
[CUSTOMER][NEUTRAL] Uh, the date, the date of service is um [PII]. The total amount $1,421 is 36 cents.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And can you verify the name of the provider's office that would be on the claim?
[CUSTOMER][NEUTRAL] Um, individual is [PII]. Our group name is Gastroenterology and Motility Center.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Let me check this other one, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Alright, so I'm showing received the claim on [PII].
[AGENT][NEUTRAL] That claim number is 3589442.
[AGENT][NEUTRAL] And on [PII], we paid on on the claim to the provider, um, a total of $171.76.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And did you need the check number or anything?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, it was, how was this paid? Was it uh uh a check issue electronically? How was it?
[AGENT][NEUTRAL] It was a single check mailed to you. Um, hold on one second, let me get that information for you.
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] Hold on 1 2nd.
[AGENT][NEUTRAL] 20
[AGENT][NEUTRAL] OK, wait a minute.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I wrote the um check number wrong. I'm sorry. Hold on one second, it's coming up now.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so the check number um is 203.
[AGENT][NEUTRAL] 9090.
[AGENT][NEUTRAL] It was issued on [PII].
[AGENT][NEUTRAL] It was mailed to address [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] In [PII].
[CUSTOMER][NEUTRAL] OK. You have
[CUSTOMER][NEUTRAL] Do you have [PII]?
[AGENT][NEUTRAL] No, it doesn't say [PII]. Hold on one second, let me see the doc [PII].
[AGENT][NEUTRAL] Do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] It's the last one. I hope this is it.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right, thank you so much for holding. I apologize for that wait. I was taking a look at the documents that was received to see what the billing address that came over was so that we can correct it, um because the check is still outstanding, um, but
[AGENT][NEUTRAL] On the claim form, it doesn't list a suite number, so that's why it wasn't sent to one. all we need is a corrected claim form with the full correct address and we can go ahead and correct it.
[CUSTOMER][NEUTRAL] A W-9 form.
[AGENT][NEUTRAL] It doesn't have to be a W9. It could be the same claim form. It just needs to list the suite number we need to send it to.
[CUSTOMER][NEUTRAL] OK, cause I mean that we send everything electronically and it should have been there.
[AGENT][NEUTRAL] Right, so like when I pull up the documents and I look at the claim form in box 33, I see your address, but it doesn't have a suite number and that's what we take the address from. So if you want to send another claim form and just put the correct address in box 33, we can issue the check.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] On box 33.
[AGENT][NEUTRAL] Um where it says billing provider info and phone number. It has the full address, it just doesn't show the suite number to send it to.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If you like to send if the W9 is easier, you can. It's just uh
[AGENT][NEUTRAL] We just really go off the claim form, but whichever is easier for you all to send over.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, I'm probably gonna try to do both just in case of future um reference and other claims, so they could have it there.
[AGENT][NEUTRAL] OK, um, it's up to you, whatever your preference is.
[CUSTOMER][NEUTRAL] So, where do I practice?
[AGENT][NEUTRAL] So it goes to, hold on one moment, let me make sure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I don't wanna give you claims if it goes to a specific person. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so the W9 should go to um fax number 844.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 539.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 3507.
[CUSTOMER][NEUTRAL] And what will be the turnaround time with either or?
[AGENT][NEUTRAL] Um, it's the same 7 to 10 business days.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Now, [PII], I do have, maybe the same issue happened but um with the same patient, another, another claim, but it was um the um
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, hold on one second, let me see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what was the total bill for that?
[CUSTOMER][NEUTRAL] That one was 1 $1,079.84.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, now this one we received a few claims for this day. Do you mind if I place you on just a brief hold? I'm just gonna go through them.
[CUSTOMER][NEUTRAL] I'm sure.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Now, can you repeat the um total bill for this one?
[CUSTOMER][NEUTRAL] Um, for this one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, I'm on the same one.
[CUSTOMER][NEUTRAL] $1,079.84.
[AGENT][NEUTRAL] OK. I just wanted to make sure I got it on the 1st 1. Hold on one second.
[CUSTOMER][NEUTRAL] Mhm. I'm sure.
[AGENT][NEUTRAL] So let me see what happened on this one.
[AGENT][NEUTRAL] Mhm. Same thing. Um, there's no suite number. So whether you send the W9 or the claim form, um, the address for the whole, your whole pro Well, how do I say that, your whole office will be updated so that any claims that come in will go to the correct address.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, that's why I think, yeah, that's what we've been doing because we've been having an issue when it came to the address with several different insurances. So that's why I have that one ready to go, basically.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So now this one was received. Can you give me the check number, claim number, and all of that so I could say it. Mhm.
[AGENT][NEUTRAL] Oh, sure.
[AGENT][NEUTRAL] So this one was received um both um [PII].
[AGENT][NEUTRAL] Um, and it was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that claim number is 358.
[AGENT][NEUTRAL] 9447.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the check number, let me know when you're ready.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, the check number is 203.
[AGENT][NEUTRAL] 9092.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the, and the amount?
[AGENT][NEUTRAL] The amount was 7.
[AGENT][NEUTRAL] $60.86.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome, [PII]. Thank you so much then for your help. I'll be faxing that over to you guys now. Can I just have a, a reference card number, please, the first initial to your last?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date, and the first initial to my last name is [PII].
[CUSTOMER][POSITIVE] No. Thank you so much. Then you have a great day.
[AGENT][POSITIVE] You also, was there anything else I can help you with today?
[CUSTOMER][POSITIVE] That will be all honey.
[AGENT][POSITIVE] Alright, thanks for calling APL. Have a great weekend.
[CUSTOMER][NEUTRAL] You too. Mm bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.