AccountId: 011433970860
ContactId: d8ed8cce-719d-44c7-957f-253a7b1443e3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 475850 ms
Total Talk Time (AGENT): 145643 ms
Total Talk Time (CUSTOMER): 186609 ms
Interruptions: 2
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/d8ed8cce-719d-44c7-957f-253a7b1443e3_20250624T16:16_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, hi, good morning. This is [PII]. I'm calling from the provider's office, checking on a member's claim.
[AGENT][NEUTRAL] OK, I can verify claim status for you, [PII], and what is the policy number, please?
[CUSTOMER][NEUTRAL] Um, that's gonna be 024.
[CUSTOMER][NEUTRAL] 603-38.
[AGENT][NEUTRAL] Thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Of course. Uh that's [PII].
[CUSTOMER][NEUTRAL] [PII] and that's a direct line.
[AGENT][NEUTRAL] OK, thank you. And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] That's gonna be uh [PII].
[CUSTOMER][NEUTRAL] With the date of birth, that's [PII].
[AGENT][NEUTRAL] OK, thank you and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Date of service is [PII] and the total bill amount 3717 even.
[AGENT][NEUTRAL] OK, and the balance after primary?
[CUSTOMER][NEUTRAL] Uh, the balance of the primer is 816 even.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, of course. And pardon me, but I could catch your name at first.
[AGENT][NEUTRAL] Sure it's [PII] last initial [PII] and what's the name of the provider's office?
[CUSTOMER][NEUTRAL] That's gonna be Kainate Saint Mary's Hospital.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, it shows the claim processed on [PII] and a check was mailed in the amount of $816.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, check for mail, but um actually we had received one correspondence um on uh let me just have a look at that.
[CUSTOMER][NEUTRAL] Uh, that would be on, uh, [PII] of this year and it is stating that there is some issue with the name and the tax ID combination, and you guys have requested some information to be sent out to you.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Uh yes, please.
[AGENT][NEGATIVE] I don't show for this claim that we were uh needing information from the IRS with the discrepancy. This one was paid.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, so uh we exclude this letter that you have sent us?
[AGENT][NEUTRAL] I'm not sure if it's under another, is it under the same patient or for the same data service or is it for a different data service?
[CUSTOMER][NEUTRAL] Oh, actually we have, uh, for this this patient only [PII] and [PII] date of service [PII].
[CUSTOMER][NEUTRAL] And I have a patient account number too, that is uh on the correspondence on your letter.
[AGENT][NEUTRAL] What's the patient account number?
[CUSTOMER][NEUTRAL] That's 351.
[CUSTOMER][NEUTRAL] 328-737.
[AGENT][NEUTRAL] OK, well, I don't see it, but I do show a check has been issued.
[AGENT][NEUTRAL] So, if it's asking for the information, have the provider contacted the IRS in regards to the discrepancy?
[CUSTOMER][NEUTRAL] Um, actually, I don't know that I thought that you would be, uh, like help me out with that detail.
[AGENT][NEUTRAL] Well, I don't show we received any information. So if the provider we didn't contact or get in contact with the IRS once they show that discrepancy has been corrected, then they need to submit us information and then I guess they would reprocess or send out a check but until that information is received, that's just I guess in pending status.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][MIXED] OK, but the check was issued for 816, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. When was it issued on?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Uh, can I get the check number or the EFT number, please?
[AGENT][NEUTRAL] Check number [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 1869294, was it a single or a bulk one?
[AGENT][NEUTRAL] Single.
[CUSTOMER][NEUTRAL] Single. OK. And uh can I get the claim number, please?
[AGENT][NEUTRAL] 349-536-7.
[CUSTOMER][NEUTRAL] OK. OK. OK, [PII], can you just uh help me out with one thing. Uh, can you uh fax us a copy of this EOB if that is possible?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] What is the fax number?
[CUSTOMER][NEUTRAL] Um, that's gonna be 214.
[CUSTOMER][NEUTRAL] 216.
[CUSTOMER][NEUTRAL] 1951.
[AGENT][NEUTRAL] OK, and that's [PII]. Is that correct?
[CUSTOMER][POSITIVE] Yes, absolutely.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, is there?
[CUSTOMER][NEUTRAL] And put an attention to my name.
[AGENT][NEUTRAL] [PII]? OK. And is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um, uh, no, you just help out everything. Last question, uh, that is for this one, for this IRS one, so is it pending on your end so that, uh, so we, so, uh, like I can, uh, escalate this to the provider so that the provider can contact the IRS to get, uh, this description.
[AGENT][NEUTRAL] Yes, the provider we need to contact the IRS.
[CUSTOMER][NEUTRAL] OK. And after that, uh, do we need to send something to you like any information with a W-9 form or anything like that?
[AGENT][NEUTRAL] Yes, once it has been corrected with the IRS, then it would need to be submitted to our office.
[CUSTOMER][NEUTRAL] OK. And uh we would be mailing it out, right?
[AGENT][NEUTRAL] You can mail it or fax it.
[CUSTOMER][NEUTRAL] Those information?
[CUSTOMER][NEUTRAL] Oh, can I have the fax number, please?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I'm just repeating it. [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Would there be any attention, specific attention to it?
[AGENT][NEGATIVE] Uh, no.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Go straight to our claims department.
[CUSTOMER][NEUTRAL] Um, oh, claims department. OK, can I get a reference please for today's call?
[AGENT][NEUTRAL] You may use my name at today's date.
[CUSTOMER][POSITIVE] OK, thanks a lot. Thanks a lot, sir. Thank you.
[AGENT][POSITIVE] You're welcome thanks for calling APL bye.
[CUSTOMER][NEUTRAL] Bye bye.