AccountId: 011433970860
ContactId: d8a80760-4ebb-4190-8730-cdd2c25cb60c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 391929 ms
Total Talk Time (AGENT): 144722 ms
Total Talk Time (CUSTOMER): 135716 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/d8a80760-4ebb-4190-8730-cdd2c25cb60c_20250219T18:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling you from provider's office, checking on claim status.
[AGENT][NEUTRAL] OK, I can check on a claim for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. [PII]. It's a direct line.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right. And then uh do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah. The policy number is 02555046.
[AGENT][NEUTRAL] Thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that, [PII]. Uh, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yeah, date of service is [PII]. Total charge $288 even.
[AGENT][NEUTRAL] OK, and that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] And [PII], I'm sorry, what, uh, what was the name of the provider this is with?
[CUSTOMER][NEUTRAL] Uh, Holy Cross Medical Group. Do we need the individual provider name?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh no, that's OK. I do have it as Holy [PII]. I believe I found it. Um, what was the remaining balance after major medical paid?
[CUSTOMER][NEUTRAL] Yeah, just give me one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Calculate that one.
[CUSTOMER][NEUTRAL] Yeah, the remaining balance was.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] $288 even.
[AGENT][NEUTRAL] OK, so we, I did find this claim, so we paid a benefit of $53.89. Would you give me one moment, I will get that uh claim and check information for you.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, uh, did you need that claim number?
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK, the claim number is 356-053-3.
[CUSTOMER][NEUTRAL] OK. And uh may I know the mode of payment?
[AGENT][NEUTRAL] OK, I'm gonna
[AGENT][NEUTRAL] Yes, it was a check uh that we mailed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get the check number?
[AGENT][NEUTRAL] Mhm. That is 2026498.
[CUSTOMER][NEUTRAL] OK, and when was the check issued?
[AGENT][NEUTRAL] That was issued [PII].
[CUSTOMER][NEUTRAL] OK, it was issued on [PII]. OK, it was a single check or bulk check amount.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] It's a single check $53.89.
[CUSTOMER][NEUTRAL] 89 cents. OK. And uh can you please verify me the mailing address?
[AGENT][NEUTRAL] Yes, so we've sent that to that was [PII].
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Could you please repeat once again?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, could you please repeat once again the check to address?
[AGENT][NEUTRAL] Oh sure, yeah, so the address was [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. OK. Yeah. As per checking, uh, the check has been paid to incorrect address. Our pay to address is [PII]. Can you please reissue a check to this address?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I'm unable to reissue the check out until after 30 days. Uh, however, even if that address was incorrect, we would have to have a corrected claim form with that correct address on it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you are suggesting me to submit W9 form, I'm right?
[AGENT][POSITIVE] Yes, that's perfectly fine.
[CUSTOMER][NEUTRAL] OK. And uh can we submit the DNA form through fax?
[AGENT][POSITIVE] Yes, absolutely.
[CUSTOMER][NEUTRAL] Yeah, can I get your fax number?
[AGENT][NEUTRAL] Yes, that is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] To confirm, it's [PII]. Am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And what will be the attention?
[AGENT][NEUTRAL] Claims department.
[CUSTOMER][NEUTRAL] Claims department. OK, sure. And uh may I know the claim received date?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, give me just a moment let me get that for you, and I can send you a copy of this EOB too if you'd like, [PII].
[CUSTOMER][NEUTRAL] Uh, uh, no, uh, however, the check has been paid to and correct it doesn't need the EOB.
[AGENT][NEUTRAL] OK, so this claim was received [PII].
[AGENT][NEUTRAL] And it was processed [PII].
[CUSTOMER][NEUTRAL] OK, sure. Thank you. Just to confirm, the claim number is 356-053-3. I'm right?
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] OK, sure. And may I have your name spelled, please?
[AGENT][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] Initial for last name?
[AGENT][NEUTRAL] A
[CUSTOMER][POSITIVE] OK, sure. It was great speaking with you. Have a good day. Bye-bye.
[AGENT][NEUTRAL] Yeah, was there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, no, thank you.
[AGENT][POSITIVE] OK, yeah, thanks for calling APL. Have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye.