AccountId: 011433970860
ContactId: dce9519b-958b-4ef8-9768-5eb28c3fbd54
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 418920 ms
Total Talk Time (AGENT): 230719 ms
Total Talk Time (CUSTOMER): 126836 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/dce9519b-958b-4ef8-9768-5eb28c3fbd54_20250317T15:22_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Um, I'm having an issue getting your guys's payments to go over to my guy to your account. Um, I did receive an explanation of benefits from you guys dated [PII] for the check of $4750 and that is not posted to my guys to your account.
[AGENT][NEUTRAL] So, are you an insured or you're a provider?
[CUSTOMER][NEUTRAL] Uh, so I'm insured.
[AGENT][NEUTRAL] OK, I just need to know how to um which way to handle it, but I can definitely look into it for you. So you're saying that you, you're supposed to be receiving a claims check and it says that it came out, but you haven't received it yet.
[CUSTOMER][NEGATIVE] Yeah, so they've been sending the check directly to Gy Singer, not me, and [PII] has not received it, and they're threatening to send me to collection for something I know I don't know.
[AGENT][NEUTRAL] Is that right? OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] What, oh, [PII] is the pro. OK, OK, so we're sending the check to the, we're saying we're sending the check to the provider, but they haven't received it and they're billing you.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, I got it. OK. Well, I can definitely look into that for you. I'm sorry you have to, you're going through that. Um, let me see what's going on. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] OK, let's see, the policy number is 02581804.
[AGENT][NEUTRAL] OK, thank you, hold on one moment.
[AGENT][NEUTRAL] OK. And I have your policy here. Can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] Um, my date of birth is, uh, [PII]. I'm, I'm sorry, [PII]. Um, my mailing address should be [PII], which I did just change that. Um, so if not it would be [PII] would be my previous address, and then my email is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and thank you so much for verifying your information and all the information provided is a verification of benefits, not a guarantee of payment. So, um, the [PII] is on there, so that's the correct address, right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, good. All right, and then let me look at, you said the, what's the date of service for the claim or do you have the claim number there?
[CUSTOMER][NEUTRAL] Um, I do have the claim number if that'll help you. The claim number is 3549457.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 57. OK, hold on one moment.
[CUSTOMER][NEUTRAL] And the date of service should be [PII].
[AGENT][NEUTRAL] Something. OK, here we go.
[AGENT][NEUTRAL] OK, so.
[AGENT][POSITIVE] The check is still outstanding. Let me see if anyone from so that.
[AGENT][POSITIVE] So we did send it but it's still outstanding. So I wonder if this is address change, OK, that's your address change. I'm just looking through the notes to see.
[AGENT][NEUTRAL] So then
[AGENT][NEUTRAL] So there's 2 things that we can do. We sent out the check, but it's still outstanding, so they may, may not have received it. I mean, they can call and verify the the address with us, or they can send us over a corrected claim with the address that it's supposed to if it went, I can give you the information to where it went.
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Yeah, that'd be awesome.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the, you just want me to give you all the check information? Do you have it already? Or you need it? I can give it to you.
[CUSTOMER][NEUTRAL] Um, so I have the explanation of benefits, but I like I called them about a month ago, uh, and they said they're just waiting to receive it, so like I don't know if I got lost somewhere, like if you can resend it or what.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so on, well, let me give you the check information and then on our end, I'm also going to send um to our representative. She like checks the checks and sees if they've cleared, you know, handles the checks on that end. So I'll send her this claim and this information so she can check on the check and then if we need to reissue it, we definitely could. They haven't notified us that they didn't receive the check. So, um, I'm gonna go ahead and let her know so we can get that ball rolling.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then if they need
[CUSTOMER][POSITIVE] That'd be awesome.
[AGENT][NEUTRAL] And then if they, you know, wanna, once you give them this address that we sent it to, you know what, maybe we should wait because if she reissues it and this is wrong, let's wait to talk to them first.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEGATIVE] Because just because if she does reissue it and this is the wrong address and we haven't heard back, I don't want it to be sent again.
[CUSTOMER][NEUTRAL] OK, uh, so what, what address did you send it to?
[AGENT][NEUTRAL] So it's [PII].
[CUSTOMER][NEUTRAL] OK, and where where would that [PII] be?
[AGENT][NEUTRAL] And it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right perfect um so should I give them a call and confirm that address but what should I do?
[AGENT][NEUTRAL] So, you can give them a call, yes, and confirm the address. If the address is correct, um, you can give us a call and let us know. I'm the only [PII] here, so if you want to ask for me, that's totally fine. And I'll go ahead and send the request to [PII] to um reissue the check. And then if it's incorrect, they're going to have to send a corrected claim with the correct, you know, information on which where to send it to.
[CUSTOMER][POSITIVE] OK perfect I will give them a call.
[AGENT][NEUTRAL] Alright, well
[CUSTOMER][POSITIVE] And see if that's right.
[AGENT][POSITIVE] Well, I will go ahead and note your policy and then um once you, once you get the information, um, the notes will be there, but if you do want to ask me, I'm the only [PII] here, so I'll be more than happy to help you.
[CUSTOMER][POSITIVE] All right perfect thank you so much for your help.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Uh, I believe that's all.
[AGENT][POSITIVE] All right, have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you bye bye.